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K5. If you are currently involved in a marital or romantic relationship, how satisfactory is this <br /> relationship? <br /> a. Does not apply; I am not currently involved in a marital or romantic relationship. <br /> b. Very satisfactory <br /> c. Somewhat satisfactory <br /> d. Somewhat unsatisfactory <br /> e. Very unsatisfactory <br /> K6. Have conflicts in your personal relationships interfered with your job performance? <br /> a. No. I have not had conflicts in personal relationships <br /> b. No. I have had conflicts, but they have not interfered with my job performance <br /> c. Yes. I have had conflicts that have interfered with my job performance <br /> K7. Have you ever slapped, punched, or otherwise struck or injured a spouse or romantic <br /> partner? <br /> a. No <br /> b. Yes,on one occasion <br /> c. Yes,on 2 or 3 occasions <br /> d. Yes,on 4 or more occasions <br /> K8. During the last three years,did you ever slap, punch, or otherwise strike or injure a spouse <br /> or romantic partner? <br /> a. No <br /> b. Yes, on one occasion <br /> c. Yes,on 2 or 3 occasions <br /> d. Yes, on 4 or more occasions <br /> K9. Has a spouse or romantic partner ever slapped, punched, or otherwise struck or injured <br /> you? <br /> a. No <br /> b. Yes,on one occasion <br /> c. Yes,on 2 or 3 occasions <br /> d. Yes,on 4 or more occasions <br /> K10. During the last three years, has a spouse or romantic partner ever slapped, punched, or <br /> otherwise.struck or injured you? <br /> a. No <br /> b. Yes,on one occasion <br /> c. Yes,on 2 or 3 occasions <br /> d. Yes,on 4 or more occasions <br /> K11. Have police ever responded to your home because of a domestic disturbance that involved <br /> you? <br /> a. No <br /> b. Yes <br /> K12. Have you ever committed, or been accused of committing, threats of physical harm, or <br /> stalking, directed at a spouse or romantic partner? <br /> a. No <br /> b. Yes, 1 time <br /> c. Yes,2 times <br /> d. Yes,3 or more times <br /> PSS/LEPS PLLC 93 <br />