B. How often did this happen during the last 12 months: often, only sometimes, or not at all?
A. Did your (last) (husband/partner) ever do any of the following things to you:
B. How often did this happen during the last 12 months: often, only sometimes, or not at all?
a) push you, shake you, or throw something at you?
b) slap you?
c) twist your arm or pull your hair?
d) punch you with his fist or with something that could hurt you?
e) kick you, drag you, or beat you up?
f) try to chock you or burn you?
g) threaten you with a knife, gun, or other type of weapon?
h) physically force you to have sexual intercourse with him even when you did not want to?
i) physically force you to perform other sexual acts you did not want to?
j) Force you with threats or in any other way to perform sexual acts you did not want to?
B) How often did this happen during the last 12 months: often, only sometimes, or not at all?
1105B. How often did this happen during the last 12 months: often, only sometimes, or not at all?
1107B. How often did this happen during the last 12 months: often, only sometimes, or not at all?
1405B) IF YES: How often did this happen during the last 12 months: often, only sometimes, or not at all?
a) push you, shake you, or throw something at you?
b) slap you?
c) twist your arm or pull your hair?
d) punch you with his fist or with something that could hurt you?
e) kick you, drag you, or beat you up?
f) try to choke you or burn you on purpose?
g) threaten you or attack you with a knife, gun, or other type of weapon?
h) physically force you to have sexual intercourse with him even when you did not want to?
i) physically force you to perform other sexual acts you did not want to?
j) force you with threats or in any other way to perform sexual acts you did not want to?
B) How often did this happen during the last 12 months: often, only sometimes, or not at all?
1305B) How often did this happen during the last 12 months: often, only sometimes, or not at all?
a) push you, shake you, or throw something at you?
b) slap you?
c) twist your arm or pull your hair?
d) punch you with his fist or with something that could hurt you?
e) kick you, drag you, or beat you up?
f) try to choke you or burn you on purpose?
g) threaten or attack you with a knife, gun, or other weapon?
h) physically force you to have sexual intercourse with him when you did not want to?
i) physically force you to perform any other sexual acts you did not want to do?
j) force you with threats or in any other way to preform sexual acts you did not want to?
A. Did your (last) (husband/partner) ever do any of the following things to you:
B. How often did this happen during the last 12 months: often, only sometimes, or not at all?
B. How often did this happen during the last 12 months: often, only sometimes, or not at all?