Family and Domestic Violence Risk Assessment Tool

Service providers that have a role in responding to family and domestic violence are required to conduct a risk assessment considering the adult victim’s assessment of the risk, evidenced based key risk factors and the service provider’s professional judgement.

1 Summary

Victim details	Perpetrator details
Name: .	Name: .
Date of birth: .	Date of birth: .
Phone number: .	Phone number: .
Address: .	Address: .
Emergency contact: .
Nature of relationship between victim / perpetrator: .
Name(s) and date(s) of birth of children: .

Completed by:

Name: .	Date completed: .
Agency: .	Phone: .
Initial assessment
Level of FDV risk	☐ At HIGH RISK of serious harm	☐ At RISK of harm
Levels of risk are defined in Section 5 Assessment / Analysis.
Critical or imminent safety concerns
Please list any immediate concerns .
2 Risk factor identification
Violence toward victim/s
Risk factor	Yes	No	Unknown	Source of information if not adult victim (e.g. Police)
Was a weapon used by the perpetrator in most recent event*	☐	☐	☐	.
Is the violence becoming worse or more frequent*	☐	☐	☐	.
Has the perpetrator ever physically harmed or threatened to harm adult victim*	☐	☐	☐	.
Has the perpetrator ever raped or sexually assaulted adult victim*	☐	☐	☐	.
Has the perpetrator ever choked, strangled or suffocated the adult victim or attempted to do so*	☐	☐	☐	.
Has the perpetrator ever tried or threatened to kill the adult victim*	☐	☐	☐	.
Is the perpetrator stalking the adult victim (could include harassing and/or monitoring the adult victim using others and/or technology)*	☐	☐	☐	.
Is the perpetrator jealous and/or controlling toward the adult victim*	☐	☐	☐	.
Has there been a recent separation or planned separation in the near future*	☐	☐	☐	.
Has the perpetrator ever harmed or threatened to harm or kill children*	☐	☐	☐	.
Has the perpetrator ever harmed or threatened to harm or kill pets or other animals*	☐	☐	☐	.
Has the perpetrator ever harmed or threatened to harm or kill other family members	☐	☐	☐	.
Has the perpetrator isolated the adult victim from family, friends and/or other social supports	☐	☐	☐	.
Has the perpetrator restricted the adult victim’s access to money	☐	☐	☐	.
Perpetrator
Risk factor	Yes	No	Unknown	Source of information if not adult victim (e.g. Police)
Does the perpetrator have access to firearms or prohibited weapons*	☐	☐	☐	.
Has the perpetrator ever threatened or attempted suicide*	☐	☐	☐	.
Does the perpetrator misuse/abuse drugs and/or alcohol*	☐	☐	☐	.
Has the perpetrator ever experienced mental ill health#	☐	☐	☐	.
Is the perpetrator unemployed	☐	☐	☐	.
Is the perpetrator experiencing financial difficulties	☐	☐	☐	.
Has the perpetrator breached any court orders (i.e. bail, violence restraining order and/or police order conditions)	☐	☐	☐	.
Is the perpetrator currently on bail or parole in relation to violent offences	☐	☐	☐	.
Has the perpetrator served a time of imprisonment or been released recently from custody in relation to violent offences	☐	☐	☐	.
Does the perpetrator have a history of violent behaviour (not family violence)	☐	☐	☐	.
Does the perpetrator’s family pose a risk to the adult victim	☐	☐	☐	.
Children
Risk factor	Yes	No	Unknown	Source of information if not adult victim (e.g. Police)
Is the adult victim pregnant or is there a new birth*	☐	☐	☐	.
Has the child ever been in the adult victim’s arms when she/he has been attacked*	☐	☐	☐	.
Has the child ever tried to intervene in the violence	☐	☐	☐	.
Are there child contact or residency issues and/or are there current Family Court proceedings	☐	☐	☐	.
Are there children from a previous relationship present in the household	☐	☐	☐	.
# The presence of mental ill health must be carefully considered in relation to the co-occurrence of other risk factors. * These risk factors indicate an increased likelihood of a victim being killed.
3 Adult victim’s assessment of the risk
How fearful is the adult victim of the perpetrator	☐ Not afraid	☐ Afraid	☐ Terrified	☐ Unable to answer
What concerns did the adult victim express?	.
What did the adult victim think the perpetrator might do and to whom?	.
Other important comments	.

4 Professional judgement
Are you aware of any other additional factors, circumstances or details which make you believe there is risk or high risk to the safety of the adult victim, children and/or others?	.
Issues to consider may include: the adult victim’s situation in relation to disability, substance misuse, mental health issues, cultural/ language barriers; whether they are willing to engage with a support service; whether the perpetrator’s occupation or interests has given them unique access to weapons etc.	.
Do you believe any children in the household are at risk of harm?	.

5 Assessment/Analysis
Level of FDV risk	Select appropriate level of risk based on professional judgement, evidenced base risk factors and the victim's own perception of their level of risk where available.
☐ At HIGH RISK of serious harm At high risk of serious harm means there is evidence of a serious risk to the adult victim and children’s safety and wellbeing and urgent action is necessary to prevent or lessen the risk. A victim is identified as at high risk of serious harm if: a number of factors with an (*) are checked 'yes' on the risk assessment tool; there is a history of physical violence by the perpetrator toward the adult and child victims (if there are children); and/or in your professional judgement, combined with evidence based risk factors, the adult and child victims (if there are children) are likely to be in grave danger if immediate action is not taken.	☐ At RISK of harm At risk of harm means there is evidence of a risk to the adult victim and children’s safety and wellbeing. A victim is identified as at risk of harm if: one or more risk factors are checked 'yes' on the risk assessment tool; there is a history of violence by the perpetrator toward the adult and child victims, and/or the violence is escalating.

6 Responding to the level of risk
Next steps	Details of action
☐ Immediate safety addressed	.
☐ Safety plans developed	.
☐ Agency collaboration & information sharing	.
☐ Warm referrals made for: ☐ Adult victim ☐ Children ☐ Perpetrator	.
☐ Multi-agency meeting convened	.
☐ Police contacted	.
☐ VRO application	.
☐ Child protection notified	.
☐ Other	.
☐ Are these next steps working toward making it safer for the adult and child/ren victims?
☐ Are these next steps holding the perpetrator accountable for their violence?

NB: The above is a non-exhaustive list of actions to be taken. Every case is unique and appropriate actions will be dependent on the outcome of the family and domestic violence risk assessment.

This risk assessment tool is based on comprehensive research including multiple examinations of the predictive accuracy of risk factors, victim perception and professional judgement in assessing risk of repeat assault or potential lethality in family and domestic violence cases (Campbell 2003; 2004; 2005). See Fact sheet 5 Key risk factors for further information and references.