Have you experienced any of the following things from your partner?        "X" the responses that apply to you……. _____ Withheld approval, appreciation or affection as punishment _____ Ignored your feelings _____ Humiliated, ridiculed or insulted you in public or private _____ Continually criticized you, called you names, shout at you, etc. _____ Refuse to work or share the income _____ Kept you from working, going to school, volunteering, etc. _____ Controlled your money and made all financial decisions _____ Threaten to hurt you or kill you _____ Threaten to hurt the children, your family, or friends _____ Threaten to kidnap the children or keep you from seeing them _____ Abused the household pets in front of you or to hurt you _____ Taken the car keys or did something to the car so it would not run _____ Taken money away from you _____ Harassed you at work, call you at work, call you to check up on you _____ manipulated you with lies or contradictions _____ Told you about affairs or outside relationships he/she had _____ Accused you of having an affair _____ Told you about drugs/alcohol used as a means of hurting you _____ Destroyed property, punched walls, etc. _____ Pushed shoved or grabbed you _____ Prevented you from leaving, keeping you in a room _____ Slapped you _____ Kicked, pinched or bit you _____ Hit you with a fist or an object _____ Thrown objects at you _____ Beaten you unconscious _____ Tied you up/locked you up _____ Locked you out of the house _____ Abandoned you in a dangerous place _____ Refuse to help you when you are sick or hurt _____ Drove recklessly while you were in the car _____ Threaten you with a weapon _____ Threaten to take or taken your medication The amount of "x"s you list is not important.   What is important is that you recognize that these are forms of abuse and are present in your life.   NO ONE has the right to abuse another person.   You are not alone, there is assistance 24-hours per day at the CHOICES Domestic Violence Program. All the services are free and confidential.