Personalized Safety Plan

Step 1. Safety during violence. I can use the following options:

  1. If I decide to leave, I will_________________________________________________.
  2. I can keep a bag ready and put it____________________________________so I can leave quickly.
  3. I can tell__________________about the violence and have them call the police when violence erupts.
  4. I can teach my children to use the telephone to call the police and the fire department.
  5. I will use this word code_____________________for my children, friends, or family to call for help.
  6. If I have to leave my home, I will go______________________________________________.
  7. I can teach these strategies to my children.
  8. When an argument starts, I will move to a safer room such as ______________________________.
  9. I will use common sense and gut feeling. I will protect myself and my children until we are out of danger.

Step 2. Safety when getting ready to leave. I can use the following strategies:

  1. I will leave money and an extra set of keys with_________________________________________.
  2. I will keep important documents and keys with__________________________________________.
  3. I will open a savings account by this date_________________________to increase my independence.
  4. Other things I can do to increase my independence are:___________________________________.
  5. The shelter’s crisis line number is_________1-866-634-4198 or 634-4198_____________________.
  6. I will keep change for phone calls with me at ALL times. I know that if I use a telephone calling card, the following month the telephone bill will tell the batterer who I called after I left. I will keep this information confidential by using a using a friend’s telephone card, calling collect, or using change.
  7. I will check with_________________________and __________________________to know who will let me stay with them or who will lend me money.
  8. I can leave extra clothes with_________________________________________________.
  9. I will review my safety plan every___________________________(time frame) in order to plan the safest route. I will review the plan with__________________________________(a friend, counselor).
  10. I will rehearse the escape plan and practice it with my children.

Step 3. Safety At Home. I can use the following safety methods:

  1. I can change the locks on my doors and windows as soon as possible.
  2. I can replace wooden doors with steel doors.
  3. I can install security systems – i.e. additional locks, window bars, poles to wedge against doors, etc.
  4. I can purchase rope ladders to be used for escape routes from the second floor.
  5. I can install smoke detectors and buy fire extinguishers for each floor of my home.
  6. I can install an outside lighting system that lights up when someone approaches my home.
  7. I will teach my children how to use the phone to make collect calls to me and to _________________ (friend, family, minister) if my partner tried to take them.
  8. I will tell the people who care for my children, who has permission to pick up my children. My partner is NOT allowed to.
  9. I can tell the following people that my partner no longer lives with me and that they should call the police if he is near my residence: _______________ _______________ _______________

Step 4. Emotional Health. I can do the following:

  1. If I feel depressed and ready to return to a potentially violent situation/partner, I can _________________________________________________________________________________
  2. When I have to talk to my partner in person or on the phone, I can ___________________________.
  3. I will use “I can…” statements and I will be assertive with people.
  4. I can tell myself “________________________________________________________” when I feel people are trying to control or abuse me.
  5. I can call the following people and/or places for support: ______________________________________________________________________________
  6. Things I can do to make me feel stronger are: ______________________________________________________________________________