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Physical Abuse Checklist
What kind of
physical violence is used in this relationship? Check off
all that apply during this particular relationship. Use the following codes: | |
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Physical Violence |
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Pushing |
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Shoving |
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Slapping (front and backhand) |
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Hitting |
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Grabbing |
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Spitting |
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Punching with Fist |
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Pulling Hair |
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Pinching |
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Biting |
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Clawing or Scratching |
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Kicking (shoes on or off) |
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Kneeing |
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Head Shaking |
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Head Banging |
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Choking |
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Throwing Against Wall |
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Throwing Across Room |
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Throwing on Floor or Ground |
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Throwing Against Other Objects |
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Pinning Against Wall or on Ground |
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Sitting or Standing On |
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Hanging by Neck, Arms, or Feet |
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Wrestling |
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Twisting Arms, Legs, Fingers |
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Handcuffing |
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Tying with a Rope or other Material |
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Throwing Objects |
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Hitting with Objects |
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Attempting to Drown |
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Burning |
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Forcing to Eat Non-Edible or Poisonous Substances |
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Threatening/Using a Knife |
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Threatening/Using a Gun |
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Threatening/Using an Automobile Recklessly |
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Threatening/Using Other Lethal Weapon |
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How To Get Help | |
