Have you been belittled or humiliated by a partner in front of other people in the past year?

Have any of your partners belittled or humiliated you in front of other people in the last year?

Has a male partner done things to scare or intimidate you on purpose for example by the way he looked at you, or by yelling and smashing things in the last twelve months?

How often did a male partner threaten to hurt any of your children to get you to do what he wanted or to punish you?

Have any of your partners ever insulted you or spoken to you using vulgar or aggressive language?

How often has your partner refused to speak with you for some time (a few hours, a day or for more than a day), refused to eat the food you have cooked or slept in a different room away from the bedroom you share?

How often has a male partner threatened to hurt you or someone who is important to you?

How often has your husband threatened to hurt you or someone who is important to you?

Have any of your partners ever threatened to hurt you or someone important to you?

Have you ever been threatened by a partner?