Self-Reflection questionnaire

We invite you to consider the following questions, which may help you reflect on whether you—or someone you know—might be experiencing a situation of violence.

1. Have you ever felt, or do you currently feel, emotionally or psychologically harmed by your partner, a family member, or another person?

For example, constant insults, humiliation in private or public, destruction of valued objects, ridicule, manipulation, threats, or isolation from friends or family members.

Question 1

Yes

No

2. Has your partner or another person recently hurt you or threatened to do so?

Question 2

Yes

No

3. Has anyone ever touched you inappropriately or forced you to do something with your body or someone else’s body?

For example: touching, kissing, watching you while bathing, filming, sending or showing inappropriate photos or messages, exposing intimate parts.

Question 3

Yes

No

4. Do you ever feel afraid or worried that your partner or someone else might hurt you physically?

Question 4

Yes

No

If you answered yes to any of the above questions, you may be experiencing a situation of violence.

To support you, the British Hospital has established the Gender and Generations Violence Clinic, a confidential support service where a dedicated team of professionals specialising in this field can provide guidance and answer your questions.

Gender and Generations Violence Clinic
Consultation hours: Thursdays from 2.00 pm to 4.00 pm and Fridays from 10.00 am to 12.00 noon.
Location: Parque Batlle II Clinic – 7th Floor.
Appointments: 2487 1020 ext. 2740
Other enquiries: 2487 1020 ext. 4670

In a life-threatening emergency, call 911.

You can also seek help by calling 0800 4141 o *4141 available 24 hours a day.

In cases of violence involving children or adolescents, please call 0800 5050.