HITS Domestic Violence Screening

Form Template

The Domestic Violence Screening Tool mobile app can easily be conducted to investigate intimate partner violence and domestic abuse by asking these four questions:

5,000 Companies save time and money with GoCanvas

Lumen Logo Post Consumer Brands Logo Saluda Hill Landscapes Logo Te3co Logo Two Men and a Truck Logo VIP Lighting Logo

• 1. Have you ever been hurt or threatened by your boyfriend/husband/partner?

• 2. Have you ever been hit, kicked, slapped, pushed, or shoved by your boyfriend/husband/partner? OR Have your ever been hit, kicked, slapped, pushed or shoved by your boyfriend/husband/partner during a pregnancy?

• 3. Have you ever been raped or forced to engage in sexual activity against your will?

• 4. Are you currently or have you ever been in a relationship where you were physically hurt, threatened, or made to feel afraid?

You can document potential domestic violence and/or sexual assault quickly and accurately using this screening tools app on your iPhone, iPad, or Android device. All reports are securely saved in the GoCanvas Cloud. They can be emailed or printed as a PDF if they need to be shared with members of law enforcement, domestic violence services, or health care providers. "

Features
  • Calculations
  • Submission Editing
  • Reference Data
  • Dispatch
Read More
Platforms
  • iPhone
  • iPad
  • Android
  • Windows
Read More
Integrations
  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
Read More
*The Capterra SoftwareAdvice ​and GetApp logos are a service mark of Gartner, Inc. and/or its affiliates and is used herein with permission.*

Don't take our word for it...

“I’m not a tech guy and I was able to pick this thing up in probably an hour, and actually start to build apps. I’ve done them over lunch when I’ve gotten frustrated with a process that didn’t exist in our company. So for non tech people who’ve got a problem, the support here is awesome and I’d recommend it to anybody, not just in our industry.”

Dave Kramer, PennLine Service

Connect with one of our experts today.

We’ll help you put together the right solution for your needs.

Contact Us