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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.

Time to complete

1 minute

Eligibility

The survey is open to all women and men who have faced domestic violence in any form.

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Questions for Domestic Violence Survey

1.

How often do you argue with your partner?

The answer should be a single choice:
  1. Never
  2. Rarely
  3. Sometimes
  4. Always
2.

How often do you feel afraid of your partner?

The answer should be a single choice:
  1. Never
  2. Rarely
  3. Sometimes
  4. Always
3.

How often do you feel like you're being controlled or manipulated by your partner?

The answer should be a single choice:
  1. Never
  2. Rarely
  3. Sometimes
  4. Always
4.

How often do you feel like your partner is physically or verbally abusive?

The answer should be a single choice:
  1. Never
  2. Rarely
  3. Sometimes
  4. Always
5.

How often do you feel like your partner is financially abusive?

The answer should be a single choice:
  1. Never
  2. Rarely
  3. Sometimes
  4. Always
6.

How often do you feel like your partner is using drugs or alcohol in a way that is harmful to you?

The answer should be a single choice:
  1. Never
  2. Rarely
  3. Sometimes
  4. Always
7.

How often do you feel like your partner is engaging in other forms of abuse, such as stalking or harassing you?

The answer should be a single choice:
  1. Never
  2. Rarely
  3. Sometimes
  4. Always
8.

How often do you feel like you have no way to protect yourself from your partner's abuse?

The answer should be a single choice:
  1. Never
  2. Rarely
  3. Sometimes
  4. Always
9.

How often do you feel like you have nowhere to turn for help?

The answer should be a single choice:
  1. Never
  2. Rarely
  3. Sometimes
  4. Always

Similar Ideas

  • Family violence survey form
  • Spousal abuse survey
  • Intimate partner violence survey

Here are some FAQs and additional information
on Domestic Violence Survey

What is the purpose of this survey?

The purpose of this survey is to collect data about people's experiences with domestic violence. This information will be used to help improve services and support for victims of domestic violence.

Who can take this survey?

This survey is open to anyone who has experienced domestic violence, regardless of their gender identity.

Is this survey confidential?

All information collected in this survey is confidential. Your answers will be reported in aggregate form only and your individual responses will not be identified.

What will happen to my survey responses?

Your survey responses will be stored securely and only accessed by authorized personnel. Your responses will be used to help improve services and support for victims of domestic violence.

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