Questions | Concepts |
|---|---|
Screening Date ␣␣-␣␣-␣␣␣␣ 📆 | |
Within the past year, has someone ever hit, kicked, slapped, or otherwise physically hurt you? 🔘 Yes 🔘 No | |
Has someone ever threatened to hurt you? 🔘 Yes 🔘 No | |
Has someone ever forced you to do something sexually that made you feel uncomfortable? 🔘 Yes 🔘 No | |
By who? ☑️ Partner or spouse ☑️ Unknown Person | |
Intimate Partner Violent Notes |
General
Content
Integrations