undefined
HomeAll templatesviolence formsdomestic violence restraining order form

Domestic violence restraining order form

Domestic violence restraining orders are legal documents that are issued by a court in order to protect victims of domestic violence from their abusers. The orders can include a variety of different provisions, such as prohibiting the abuser from contacting or approaching the victim, requiring the abuser to surrender any firearms, and ordering the abuser to stay away from the victim's home, workplace, or school.

3 minutes to complete

Eligibility

The person who is filing the restraining order must be a victim of domestic violence or have a reasonable fear of becoming a victim of domestic violence.

undefined

Questions for Domestic violence restraining order form

Questions

1.

Full name

The answer should be a text input.
2.

What is the name of the person you are seeking a restraining order against?

The answer should be a text input.
3.

What is the relationship between you and the person you are seeking a restraining order against?

The answer should be a text input.
4.

What is the person you are seeking a restraining order against's address?

The answer should be a text input.
5.

What is the person you are seeking a restraining order against's phone number?

The answer should be a text input.
6.

What are the specific acts of domestic violence that you are seeking protection from?

The answer should be a text input.
7.

When did these acts of domestic violence occur?

The answer should be a text input.
8.

Have you ever obtained a restraining order against this person before?

The answer should be a text input.
9.

Do you have any children with the person you are seeking a restraining order against?

The answer should be a text input.
10.

Do you currently have any pending criminal charges against the person?

The answer should be a text input.
11.

Your Home address

The answer should be a text input.
12.

Your Phone number

The answer should be a phone number.
13.

Your Email address

The answer should be an email input.
14.

Your Date of birth

The answer should be a text input.
15.

Do you have any children?

The answer should be a text input.
16.

If yes, please list their names and ages.

The answer should be a text input.
17.

Do you own any guns?

The answer should be a single choice:
  1. Yes
  2. No
18.

Has the respondent ever threatened you or your children?

The answer should be a single choice:
  1. Yes
  2. No
19.

If yes, please describe the threats.

The answer should be a text input.
20.

Has the respondent ever harmed you or your children?

The answer should be a single choice:
  1. Yes
  2. No
21.

If yes, please describe the harm.

The answer should be a text input.
22.

Has the respondent ever stalked you?

The answer should be a single choice:
  1. Yes
  2. No
23.

If yes, please describe the stalking.

The answer should be a text input.
24.

Has the respondent ever engaged in any other controlling or abusive behavior?

The answer should be a single choice:
  1. Yes
  2. No

Forms Similar to Domestic violence restraining order form

  • Domestic violence protective order form
  • Domestic violence order of protection form
  • Domestic violence survey form

Here are some FAQs and additional information
on Domestic violence restraining order form

How do I get a domestic violence restraining order?

You can get a domestic violence restraining order by filing a petition with the court.

What is a domestic violence restraining order?

A domestic violence restraining order is a court order that protects you from abuse by a family or household member.

Who can get a domestic violence restraining order?

Anyone who is a victim of domestic violence can get a domestic violence restraining order.

What does a domestic violence restraining order do?

A domestic violence restraining order can do many things, including ordering the abuser to stay away from you, your children, and your home. It can also order the abuser to stop abusing you, to attend counseling, and to give up any firearms.

How long does a domestic violence restraining order last?

A domestic violence restraining order can last up to five years.

Want to use this template?

Loved by people at home
and at work

undefined
“BlockSurvey is a simple, effective, and scalable tool for creating surveys for leadership and learning assessment. It's one of this year's best buying choices. Each month, it keeps improving and strives to serve its customers needs.”
Nelson Emilio
Personal Branding Strategist
undefined
“I use BlockSurvey to get feedback about all my activities and events. It is really easy to get started and create my first surveys! Then I could see how easy it was to share them. Now I am thinking to use BlockSurvey also within my creative process as an author in order to listen and engage with my audience, knowing that anonymity provides the most sincere and reliable answers.”
Georgina García-Mauriño
Author & Designer
BlockSurvey social proof
G2 Crowd
4.8 Star Rating
BlockSurvey social proof
Dapp.com
Editor's choice
BlockSurvey social proof
Capterra
4.9 Star Rating

What's next? Try out templates like
Domestic violence restraining order form

1000+ Templates, 50+ Categories

Explore more
undefined
Workplace violence form
This form is to be used by employers to document workplace violence incidents.
undefined
Violence against women survey
The Violence against Women Survey is a study that collects information from women about their experiences with violence, whether it was physical, sexual, or psychological. The survey also collects information on women's use of self-defense, to protect themselves from victimization.
undefined
Sexual violence survey
Sexual violence survey aims to collect data on the prevalence of sexual violence in a population. The survey is typically conducted by interviewing a sample of individuals from the population. The survey may ask about the respondent's personal experiences with sexual violence, as well as their knowledge, attitudes, and beliefs about sexual violence.
undefined
Family violence survey template
This Family violence survey is a questionnaire that can be used by organizations to conduct a survey on family violence. This template can be used to collect data on the prevalence of family violence, the types of family violence that occur, and the impact of family violence on individuals and families.
undefined
Gun violence survey
The Gun Violence Survey can be used to collect data about gun violence in a community. It can be used to collect data about the prevalence of gun violence, the types of gun violence that occur, and the factors that contribute to gun violence. The survey can also be used to collect data about the impact of gun violence on the community, and the strategies that are being used to address gun violence.
undefined
Domestic violence assessment form
Domestic violence assessment form is used by healthcare professionals to assess whether a person has been a victim of domestic violence. The form usually includes questions about the person's history of domestic violence, their current situation, and their feelings about the violence.
undefined
Domestic violence affidavit form
A domestic violence affidavit is a sworn statement that is typically used in domestic violence cases. The affidavit may be used to provide evidence of domestic violence or to request a restraining order.
undefined
Gender based violence survey
The Gender Based Violence Survey is a national survey that collects data on the prevalence of different forms of violence against women and men. The survey covers a range of topics, including physical violence, sexual violence, emotional abuse, and financial abuse. The data collected from the survey is used to inform policy and program development, and to raise awareness of the issue of gender-based violence.
undefined
Domestic violence report form
The Domestic Violence Report Form is a document that is used to report instances of domestic violence. This form can be used by individuals who have experienced domestic violence, or by witnesses to domestic violence. The form asks for basic information about the incident, including the date, time, and location of the incident, as well as the names and contact information of the parties involved. The form also asks for a description of the incident, and any injuries that were sustained.
undefined
Domestic violence restraining order form
Domestic violence restraining orders are legal documents that are issued by a court in order to protect victims of domestic violence from their abusers. The orders can include a variety of different provisions, such as prohibiting the abuser from contacting or approaching the victim, requiring the abuser to surrender any firearms, and ordering the abuser to stay away from the victim's home, workplace, or school.
undefined
Domestic Violence Survey
Domestic violence survey template is a ready to use document which can be used by anyone who wants to conduct a survey on the issue of domestic violence. This template is very easy to use and can be edited as per the requirement of the user. This template can be used by any individual or organization which wants to collect data on the issue of domestic violence.
undefined
Domestic violence victim intake form
Domestic violence victim intake forms are used by police and domestic violence agencies to gather information about an incident of domestic violence. The form is used to document the victim's account of what happened, as well as any injuries sustained. The form is also used to collect information about the perpetrator, including their name, address, and any previous history of domestic violence.

Want to create secure online forms and surveys?

Join BlockSurvey.

SHARE