Domestic Violence Screening
Michigan · Michigan State Court Administrative Office · Effective March 1, 2019
This form is a Domestic Violence Screening document used to record information about any current or past legal actions involving two parties. It asks the person filling it out to list any personal protection, domestic violence criminal, or child protective actions they know about.
The court describes it as: Court rule / statute: MCR 3.222(C)(2)(a)(v), MCR 3.223(C)(1)(a)(vi)
Where this fits in a case
General & infoInformation / general use — not tied to one step of a case
This form is used when there are actions involving parties in a court case, requiring the listing of related legal actions.
Either party may file.
Common questions
- Who fills out this form?
- The form requires information about two parties, suggesting either party may complete it. It is used in connection with a case number and court address.
- What kind of actions does this form ask about?
- It asks about personal protection actions, domestic violence criminal actions, and pending child protective actions involving the parties.
- What should I write if there are no actions?
- If there are no actions, the instructions state to write “NONE.”
Revision history
No changes recorded since we started tracking this form on October 9, 2026. The current version took effect March 1, 2019.
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