Domestic & Dating Violence
_______ withheld approval, appreciation or affection as punishment?
_______ continually criticized you, called you names or shouted at you?
_______ ignored your feelings?
_______ ridiculed or insulted your most valued beliefs, religion, race, class or sexual preference?
_______ been very jealous or harassed you about imagined affairs?
_______ manipulated you with lies and contradictions?
_______ insisted you dress the way she/he wants?
_______ humiliated you in private or public?
_______ insulted or drove away your friends or family?
_______ taken car keys or money away from you?
_______ subjected you to reckless driving?
_______ locked you out of the house?
_______ thrown objects at you?
_______ abused pets to hurt you?
_______ punched, shoved, slapped, bit, kicked, choked or hit you?
_______ raped you?
_______ threatened to kidnap the children if you leave?
_______ threatened to commit suicide if you leave?
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