Holly T. Ashley

Oh? Did I type that outloud?

Danger Assessment

(480) 442-4816

RedemptionDANGER ASSESSMENT

How serious is/was your abuse?

Circle the response that best describes your current or past relationship:

1. Does he/she check up on you and want to know where you are at all times? Calling, texting; you, your friends or family?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
2. Is he/she jealous, and does he/she accuse you of having affairs with other men or women?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
3. Does he/she tell you that you are stupid, lazy, ugly, a rotten cook, a failure as a mother, wife or no good in bed, etc.?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
4. Does he/she call you obscene names?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
5. Does he/she tell you that no one else could ever love you?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
6. Does he/she try to keep you from seeing your family or friends?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
7. Do they control the family money so that you have to account for every penny or beg or do favors for money?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
8. Do they forbid or demand that you work or if you want to work, do they make it difficult for you?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
9. Do they tell you that no one would ever hire you?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
10 Do they keep you from driving the car (hiding car keys, etc.?)
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
11. Do they have dramatic mood swings?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
12. Do they become angrier when they drink?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
13. Do they try to make you have sex when you don’t want to?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
14. Do they force you to pressure you to commit sexual acts that are unholy, immoral or illegal (homosexual or otherwise)
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
15. Have they ever broken or damaged your home, possessions, or property?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
16. Have they ever threatened to harm a pet?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
17. Have they ever killed a pet?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
18. Have they ever intentionally harmed a pet?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
19. Have they ever locked you out of the house?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
20. Do they force you to stay awake?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
21. Do they slap, punch, kick, bite, choke, pull your hair or burn you?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
22. Have they ever hurt you with an object or weapon?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
23. Have they threatened you with an object or a weapon?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
24. Do they endanger you or your children with reckless driving?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
25. Do they neglect you or the children when you need medical attention?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
26. Have they ever threatened to kill themselves, you, the children or other family members or friends?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
27. Have they ever been violent toward your children?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
28. Have they ever molested your children sexually?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
29. Are they violent towards anyone else in the family?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
30. Have you ever had to call the police or wanted to because you feared them?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
31. Have they ever been arrested for violence?
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4
32. When you tell them you are leaving – do they try to stop you? Either by force or intimidation or even coercion (crying, saying they will change or that they are sorry?)
Never – 0 Once or twice  – 2 Frequently – 3 All the time – 4

To learn how serious your abuse is/has been, please total your points.

(0 – Healthy Relationship)    (1-14 – Unhealthy)    (15-36 – Abusive)   (37-93 – Seriously Abusive)   (94+ – Dangerously Abusive – Make a Safety Plan and get help now).


Domestic Violence Hotline: 1-800-799-SAFE (7233) You can also visit: http://www.thehotline.org where help is one click away.


If you are NOT in imminent Danger and would like more information on resources, referrals or counseling – you can contact R3 Christian Domestic Violence Services by filling out the form below. None of information will not be shared with anyone.


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