Screening and Assessment in TANF\Welfare-to-Work: Ten Important Questions TANF Agencies and Their Partners Should Consider. Domestic Violence Screening Form (New York)


Barriers Identified
Domestic Violence

Number and Types of Questions
Six 'yes' or 'no' questions about physical, sexual, and emotional abuse, fear of partner, threats to the client or children, and stalking.

Target Population
TANF clients statewide

Methodological Information
Not available

It is a self-administered paper and pencil tool. The tool is given to all clients at intake and mentioned verbally, however, clients are not required to fill it out. One or more 'yes' answers lead to a referral to the Domestic Violence Specialist where the client will be expected to provide more detailed information about their situation.


Source or Publisher
New York State Department of Family Assistance (DFA)
Office of Temporary and Disability Assistance in coordination with

Office of Children and Family Services,

New York State Domestic Violence Coalition, and

legal experts


State(s) Believed to be Using
New York

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