Items:

We would like to know if you experienced any of the actions listed below from any current or former partner or partners. If it ever happened to you, please tell us how often it usually happened in the past 12 months

1. Blamed me for causing their violent behaviour
2. Shook, pushed, grabbed or threw me
3. Tried to convince my family, children or friends that I am crazy or tried to turn them against me
4. Used or threatened to use a knife or gun or other weapon to harm me
5. Made me perform sex acts that I did not want to perform
6. Followed me or hung around outside my home or work
7. Threatened to harm or kill me or someone close to me*
8. Choked me*
9. Forced or tried to force me to have sex
10. Harassed me by phone, text, email or using social media
11. Told me I was crazy, stupid or not good enough
12. Hit me with a fist or object, kicked or bit me
13. Kept me from seeing or talking to my family or friends
14. Confined or locked me in a room or other space
15. Kept me from having access to a job, money or financial resources*

Response Options:
No
Yes
IF YES, how often did it happen in the past 12 months?
Not in the past 12 months - 0
Once - 1
A few times - 2
Monthly - 3
Weekly - 4
Dailyalmost daily - 5
* These three items were not included in estimation of reliability and validation psychometrics.