1. Act in ways that scare you?

Never
Once in a while
A lot

2. Tease you in ways that hurt or embarrass you – when you’re alone or out in public?

Never
Once in a while
A lot

3. Put you down or criticize you?

Never
Once in a while
A lot

4. Hit, slap, push, kick, or restrain you?

Never
Once in a while
A lot

5. Become jealous when you talk or visit with friends, family, or co-workers?

Never
Once in a while
A lot

6. Try to control what you wear?

Never
Once in a while
A lot

7. Always need to know where you’re going and when you’ll return?

Never
Once in a while
A lot

8. Constantly call, drive by, or ask others to check up on you?

Never
Once in a while
A lot

9. Blame you if he/she hurts you – either physically or emotionally?

Never
Once in a while
A lot

10. Often get angry or moody, so you feel you’re “walking on eggshells”?

Never
Once in a while
A lot

11. Do things that frighten you – like throwing things or punching walls?

Never
Once in a while
A lot

12. Often accuse you of cheating or seeing someone else?

Never
Once in a while
A lot

13. Read your mail or go through your drawers or purse?

Never
Once in a while
A lot

14. Check your phone to see who you’ve been talking to?

Never
Once in a while
A lot

15. Make it hard to get or keep a job?

Never
Once in a while
A lot

16. Keep control of all the household money?

Never
Once in a while
A lot

17. Threaten to hurt you, your children, your pets?

Never
Once in a while
A lot

18. Threaten to commit suicide or harm him/herself if you leave?

Never
Once in a while
A lot

19. Force you to have sex when you don’t want to, or in ways you don’t want to?

Never
Once in a while
A lot

20.Ever cause you to think about calling – or call – the police because of violence or threats?

Never
Once in a while
A lot