Have you ever talked to your son or a boy you care for in the home about violence against women?

What would you do if you saw violence being carried out by a stranger (man) against a woman?

What would you do if you saw a male friend use violence against a woman?

Do you own a firearm?

Have you experienced any of the following forms of violence outside the home in the last 3 months: Other (specify)

Have you ever been involved in a fight with a knife, gun or other weapon?

Have you experienced any of the following forms of violence outside the home in the last 3 months: Been threatened with a gun

Have you experienced any of the following forms of violence outside the home in the last 3 months: Been threatened with a knife or other weapon (excluding firearms)

Have you experienced any of the following forms of violence outside the home in the last 3 months: Been punched or hit

How many times have you been arrested?