1. Do you suspect will seriously injure or kill you, the children or someone close to you? What makes you think so or not? 2. How frequently does the suspect intimidate, threaten or assault you? Is it getting better, worse or the same? 3. When were you most frightened by the suspect? . 4. Has the suspect ever threaxtened you if you sought help? 5. Does the suspect _own a gun? 6. Have you len the suspect (lf you were together) When? 7. Is the suspect working? B. Has the suspect threatened you with a weapon? 1 9. Has the suspect threatened to kill you or themselves? 1U. Has the suspect avoided arrest? 11. Has the suspect been sexually aggressive? 12. D0 you have a child that is not the suspect's? 13. Has the suspect tried to shrangle you? 14. Does the suspect use drugs/alcohol? 15. Does the suspect control your daily activities/relationships or contacts? I 16. Is the suspect jealous? 17. Has the suspect assaulted you when you were pregnant? 18. Does the suspect follow/spy or have others do the same to you? 19. Has the abuse made you contemplate suicide?