How many times has your spouse ever thrown you out of the house?

How many times has your spouse ever taken your earnings against your will?

How many times has your spouse ever prohibited you from getting a job, going to work, trading or earning money?

How many times has your spouse ever kept money from your earnings for personal use when he knew you were finding it hard to afford your personal expenses or needs for the household?

Do you own a firearm?

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

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