Have you ever been insulted by a partner or deliberately be made to feel bad about yourself?

How often has your husband belittled or humiliated you in front of other people?

Has your husband taken your earnings against your will in the last twelve months?

Has your husband kept money from his earnings for himself when he knew you were finding it hard to meet household expenses in the last twelve months?

How often has your husband taken your earnings against your will?

How often has your husband kept money from his earnings for himself when he knew you were finding it hard to meet household expenses?

How often did your husband prevent you from going to seek health services when you needed to?

Has your husband prevented you from going to seek health services when you needed to in the last twelve months?

Who has/had the final say on: Whether you can go outside the home alone?

Did any of these acts take place in front of children?