Are you asking the question to screen patients for domestic violence? To assist in this effort, ISMA’s Family Violence Committee put together, Just Ask, a brochure that provides eight steps to screen and assist victims, and an assessment questionnaire.
Domestic Violence Information Guide
Violence Info Guide is a free brochure created
for both physicians and patients. The guide discusses
the topics listed below.
- The different kinds of abuse
- How to create a safety plan
- How to obtain a protective order
- What to expect in court
The guide also provides a statewide list of shelters and non-residential support groups. This resource is free to download.
Domestic Violence Power/Control Wheel
The power/control wheel shows the different tactics an abuser may use to exert control over another person.
Domestic Violence Resource Cards
The Domestic Violence Resource cards are a small, easily concealable resource for patients who may be victims of abuse. They provide phone numbers to local shelters and non-residential programs. A safety plan is on the back.
Resource cards - $7.70 per 100 (Free to Members)
North - South - Central
Cardholders - $8.50 each
Refill orders on cards are free to members.
Domestic Violence Screening Forms:
This form provides a check-off list and a body diagram to help you record injuries. Download the form
Other Domestic Violence Resources:
ISMA e-Reports articles
Contact Rhonda Bennett to make orders
E-mail: Rhonda Bennett
Phone: (317) 261-2060