Domestic Violence Self-Assessment Survey

Our Domestic Violence Self-Assessment Survey only takes 5 to 10 minutes to complete. It is completely anonymous. All answers are simply kept for research purposes.

Answer the questions below and click “Submit” when done.

Section 1 - Communication

  • If you answered "yes" to these questions, you may be feeling that your relationship is healthy and happy.
  • If you've answered "yes" to any of these questions, you are being treated badly. Signs of abuse like these may mean that you're not safe in your relationship - and it may get worse.
 

Section 2 - Caring/Space

  • If you've answered "yes" to these questions, you may be feeling that your relationship is healthy and happy.
  • If you've answered "yes" to any of these questions, you are being treated badly. Signs of abuse like these may mean that you're not safe in your relationship - and it may get worse.
 

Section 3 - Sexual Pleasure

  • If you've answered "yes" to these questions, you may be feeling that your relationship is healthy and happy.
  • If you've answered "yes" to any of these questions, you are being treated badly. Signs of abuse like these may mean that you're not safe in your relationship - and it may get worse.
 

Section 4 - Fighting

  • If you've answered "yes" to these questions, you may be feeling that your relationship is healthy and happy.
  • If you've answered "yes" to any of these questions, you are being treated badly. Signs of abuse like these may mean that you're not safe in your relationship - and it may get worse.
 

Section 5 - Children

  • If you do not have children, please skip to Section 6.
  • If you've answered "yes" to these questions, you may be feeling that you and your partner are raising your children in healthy and happy ways.
  • If you've answered "yes" to any of these questions, your children are being treated badly. Signs of abuse like these may mean that you and your children are not safe in your family - and it may get worse.
 

Section 6 - Future

  • If you answered "yes" to these questions, you may be feeling that your relationship is going in a good direction.
  • If you've answered "yes" to some of these questions, you are in danger. You may need to make plans to get out of your relationship. Help is available.
 

Section 7 - Should you leave?

  • It's not always easy to leave a relationship, especially even when you're getting hurt and dependent upon the abuser for financial income. It's okay if you feel you cannot leave right now. Remember that your safety is important, so get information and help as soon as possible. If you're thinking about leaving, be prepared:
 

Verification

 

Domestic Violence is NOT OK!

GET OUT!

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