Danger Assessment — Intimate Partner Violence Lethality Risk

1. Has the physical violence increased in severity or frequency over the past year?

2. Does your partner own a gun?

3. Have you left your partner after living together in the past year?

4. Is your partner unemployed?

5. Has your partner ever used a weapon against you or threatened you with a lethal weapon?

6. Does your partner threaten to kill you?

7. Has your partner avoided being arrested for domestic violence?

8. Do you have a child that is not your partner's?

9. Has your partner ever forced you to have sex when you did not wish to do so?

10. Does your partner ever try to choke (strangle) you or cut off your breathing?

11. Does your partner use illegal drugs? (Street drugs or misuse of prescription medications)

12. Is your partner an alcoholic or problem drinker?

13. Does your partner control most or all of your daily activities? (Where you go, who you see, how much money you have)

14. Is your partner violently and constantly jealous of you? (e.g., 'If I can't have you, no one can')

15. Have you ever been beaten while you were pregnant?

16. Has your partner ever threatened or tried to commit suicide?

17. Does your partner threaten to harm your children?

18. Do you believe your partner is capable of killing you?

19. Does your partner follow or spy on you, leave threatening notes, destroy your property, or call you when you don't want them to?

20. Have you ever threatened or tried to commit suicide?