1308. How long after you (first got married to/started living together) did that thing(s) you just mentioned first happen? IF LESS THAN 1 YEAR, RECORD '00'. NUMBER OF YEARS_______ BEFORE MARRIAGE/BEFORE LIVING TOGETHER 95

1306. A. (Does/did) your (last) husband/partner ever: A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) B) SLAP YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) C) TWIST YOUR ARM OR PULL YOUR HAIR? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) E) KICK YOU, DRAG YOU OR BEAT YOU UP? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) B. How often did this happen during the last 12 months: often, only sometimes, or not at all? A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 B) SLAP YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 C) TWIST YOUR ARM OR PULL YOUR HAIR? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 E) KICK YOU, DRAG YOU OR BEAT YOU UP? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3

1306. A. (Does/did) your (last) husband/partner ever: A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) B) SLAP YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) C) TWIST YOUR ARM OR PULL YOUR HAIR? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) E) KICK YOU, DRAG YOU OR BEAT YOU UP? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) B. How often did this happen during the last 12 months: often, only sometimes, or not at all? A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 B) SLAP YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 C) TWIST YOUR ARM OR PULL YOUR HAIR? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 E) KICK YOU, DRAG YOU OR BEAT YOU UP? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3

1309) Did the following ever happen as a result of the actions of your (last) husband/partner: Did you have cuts, bruises or pain? Did you have eye injuries, sprains, dislocations, or burns? Did you have deep wounds, broken bones, broken teeth or any other serious injury? A) PAIN YES 1 NO 2 B) SMALL INJURIES YES 1 NO 2 C) SERIOUS INJURY YES 1 NO 2

1309) Did the following ever happen as a result of the actions of your (last) husband/partner: Did you have cuts, bruises or pain? Did you have eye injuries, sprains, dislocations, or burns? Did you have deep wounds, broken bones, broken teeth or any other serious injury? A) PAIN YES 1 NO 2 B) SMALL INJURIES YES 1 NO 2 C) SERIOUS INJURY YES 1 NO 2

1309) Did the following ever happen as a result of the actions of your (last) husband/partner: Did you have cuts, bruises or pain? Did you have eye injuries, sprains, dislocations, or burns? Did you have deep wounds, broken bones, broken teeth or any other serious injury? A) PAIN YES 1 NO 2 B) SMALL INJURIES YES 1 NO 2 C) SERIOUS INJURY YES 1 NO 2

1309) Did the following ever happen as a result of the actions of your (last) husband/partner: Did you have cuts, bruises or pain? Did you have eye injuries, sprains, dislocations, or burns? Did you have deep wounds, broken bones, broken teeth or any other serious injury? A) PAIN YES 1 NO 2 B) SMALL INJURIES YES 1 NO 2 C) SERIOUS INJURY YES 1 NO 2

1306. A. (Does/did) your (last) husband/partner ever: A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) B) SLAP YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) C) TWIST YOUR ARM OR PULL YOUR HAIR? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) E) KICK YOU, DRAG YOU OR BEAT YOU UP? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) B. How often did this happen during the last 12 months: often, only sometimes, or not at all? A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 B) SLAP YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 C) TWIST YOUR ARM OR PULL YOUR HAIR? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 E) KICK YOU, DRAG YOU OR BEAT YOU UP? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3

1306. A. (Does/did) your (last) husband/partner ever: A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) B) SLAP YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) C) TWIST YOUR ARM OR PULL YOUR HAIR? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) E) KICK YOU, DRAG YOU OR BEAT YOU UP? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) B. How often did this happen during the last 12 months: often, only sometimes, or not at all? A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 B) SLAP YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 C) TWIST YOUR ARM OR PULL YOUR HAIR? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 E) KICK YOU, DRAG YOU OR BEAT YOU UP? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3

1306. A. (Does/did) your (last) husband/partner ever: A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) B) SLAP YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) C) TWIST YOUR ARM OR PULL YOUR HAIR? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) E) KICK YOU, DRAG YOU OR BEAT YOU UP? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) B. How often did this happen during the last 12 months: often, only sometimes, or not at all? A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 B) SLAP YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 C) TWIST YOUR ARM OR PULL YOUR HAIR? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 E) KICK YOU, DRAG YOU OR BEAT YOU UP? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3

1306. A. (Does/did) your (last) husband/partner ever: A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) B) SLAP YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) C) TWIST YOUR ARM OR PULL YOUR HAIR? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) E) KICK YOU, DRAG YOU OR BEAT YOU UP? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) B. How often did this happen during the last 12 months: often, only sometimes, or not at all? A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 B) SLAP YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 C) TWIST YOUR ARM OR PULL YOUR HAIR? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 E) KICK YOU, DRAG YOU OR BEAT YOU UP? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3

1306. A. (Does/did) your (last) husband/partner ever: A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) B) SLAP YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) C) TWIST YOUR ARM OR PULL YOUR HAIR? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) E) KICK YOU, DRAG YOU OR BEAT YOU UP? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) B. How often did this happen during the last 12 months: often, only sometimes, or not at all? A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 B) SLAP YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 C) TWIST YOUR ARM OR PULL YOUR HAIR? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 E) KICK YOU, DRAG YOU OR BEAT YOU UP? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3

1306. A. (Does/did) your (last) husband/partner ever: A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) B) SLAP YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) C) TWIST YOUR ARM OR PULL YOUR HAIR? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) E) KICK YOU, DRAG YOU OR BEAT YOU UP? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) B. How often did this happen during the last 12 months: often, only sometimes, or not at all? A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 B) SLAP YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 C) TWIST YOUR ARM OR PULL YOUR HAIR? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 E) KICK YOU, DRAG YOU OR BEAT YOU UP? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3

1306. A. (Does/did) your (last) husband/partner ever: A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) B) SLAP YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) C) TWIST YOUR ARM OR PULL YOUR HAIR? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) E) KICK YOU, DRAG YOU OR BEAT YOU UP? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL? YES 1 (GO TO PART B) NO 2 (GO TO NEXT QUESTION) B. How often did this happen during the last 12 months: often, only sometimes, or not at all? A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 B) SLAP YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 C) TWIST YOUR ARM OR PULL YOUR HAIR? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 E) KICK YOU, DRAG YOU OR BEAT YOU UP? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3 J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL? OFTEN 1 SOMETIMES 2 NOT AT ALL 3

1312) Does (did) your husband/partner drink alcohol? YES 1 NO 2 (GO TO 1316)