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Do you or have you
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Yes
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No
|
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Bossed your partner around
|
|
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Pouted or denied affection (i.e.,
silent treatment) to your partner
|
|
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Checked up on them (listened to phone
calls, called them often at work, followed them)
|
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Stormed out in the middle of an
argument
|
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Insulted your partner
|
|
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Often interrupted partner while
talking
|
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Accused your partner of flirting or
cheating on you
|
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Acted jealous or suspicious of your
partner’s friends
|
|
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Blamed your partner for your problems
|
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Made negative comments on how your
partner dresses
|
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Made negative comments about your
partner’s body
|
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Kept or attempted to keep your partner
from leaving
|
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Yelled or screamed at your partner
|
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Treated your partner like a personal
servant
|
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Spit at, or pulled your partner’s
hair
|
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Slapped your partner
|
|
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Made it difficult for your partner to
socialize with friends
|
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Told your partner she/he was crazy
|
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Pushed, grabbed, shoved or threw your
partner
|
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Hit your partner with something
|
|
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Pulled or tore off your partner’s
clothes
|
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Drove fast to scare your partner
|
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Threw, hit or destroyed property
|
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Bit or scratched your partner
|
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Forced your partner to do something
she or he didn’t want to do
|
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Punched your partner with your fist
|
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Kicked your partner
|
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Choked or strangled your partner
|
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Used or threatened your partner with a
weapon
|
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Physically forced your partner to have
sex
|
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|
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Begged partner for sex and wouldn’t
stop until partner agreed
|
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|
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Physically harmed pets
|
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Threatened to hit your partner or
throw something at him or her
|
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Said things to scare him or her
(something “bad” would happen, threatened to commit suicide)
|
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Anything that hasn’t been mentioned
|
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