Domestic Violence Risk & Needs Assessment (DVRNA) 2026

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  1. Click ‘Get Form’ to open the Domestic Violence Risk & Needs Assessment (DVRNA) in the editor.
  2. Begin by entering the client's personal information, including their name, client number, date of birth, and state ID. This foundational data is crucial for accurate assessment.
  3. Proceed to Section A, where you will assess prior domestic violence incidents. Mark 'Yes' or 'No' for each question based on documented evidence.
  4. Continue through Sections B to N, evaluating factors such as substance abuse, mental health issues, and safety concerns. Each section requires careful consideration of the criteria met.
  5. After completing all sections, review your entries for accuracy. Use our platform's editing tools to make any necessary adjustments before finalizing the form.

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Forms of violence Physical violence. Any act which causes physical harm as a result of unlawful physical force. Sexual violence. Any sexual act perfomed on an individual without their consent. Psychological violence. Any act which causes psychological harm to an individual. Economic violence.
Individual Risk Factors History of violent victimization. Attention deficits, hyperactivity, or learning disorders. History of early aggressive behavior. Involvement with drugs, alcohol, or tobacco. Low IQ. Poor behavioral control. Deficits in social cognitive or information-processing abilities. High emotional distress.
Other factors which can be causes of violence include: Having low self-worth. Experiencing abuse or neglect. Witnessing violence in the home, community, or medias. Access to weapons.

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High risk means the survivor (victim) is at imminent risk of serious physical harm or death. For High Risk DA refer to MASH. A single referral to MASH will cover adults with or without children. The safety of adults and any children will be considered in MASH at the same time.

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