Personalized Safety Plan

 You may print this page if you are abused!

Suggestions for increasing safety - In the relationship

*I will have important phone numbers available to my children and myself.

*I can tell ___________ and _____________about the violence and ask them to call the police if they hear suspicious noises coming from my home.

*If I leave my home, I can go (list four places): _____________________, ________________, ____________________, or ______________.

*I can leave extra money, car keys, clothes, and copies of documents with ________________.

*If I leave, I will bring __________________________(see checklist below).

*To ensure safety and independence, I can: Keep change for phone calls with me at all times; open my own savings account; rehearse my escape route with a support person; and review safety plan on _________________(date).

 

 

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Suggestions for increasing safety - When the relationship is over

 

*I can: change the locks; install steel/metal doors, a security  system, smoke detectors and an outside lighting system.

*I will inform _____________and ________________ that my partner no longer lives with me and ask them to call the police if s/he is observed near my home or my children.

*I will tell people who take care of my children the names of those who have permission to pick them up. The people who have permission are: __________________, _________________and ______________.

 *I can tell _____________at work about my situation and ask _____________to screen my calls.

*I can avoid stores, banks, and _______________that I used when living with my battering partner.

*I can obtain a protective order from _________________. I can keep it on or near me at all times as well as leave a copy with _______________.

*If I feel down and ready to return to a potentially abusive situation, I can call ____________________for support or attend workshops and support groups to gain support and strengthen my relationships with other people.

 

 

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*I will inform the school at _____________________________ so he/she can't take my children.

 

Important Phone Numbers

 

Police____________________ Rescue/Ambulance_______________________

Hotline ___________________ Physician_____________________________

Friend____________________ Friend________________________________

Shelter ____________________ Counselor____________________________

 

Items to Take Checklist

 

 *Identification

*Birth certificates for me and my children

*Social Security cards

*School and medical records

*Money, bankbooks, credit cards

*Keys - house/car/office

*Driver's license and registration

*Medications

*Change of clothes

*Welfare identification

 *Passport(s), Green Card(s), work permits

*Divorce papers

*Lease/rental agreement, house deed

*Mortgage payment book, current unpaid bills

*Insurance papers*

Address book

*Pictures, jewelry, items of sentimental value

*Children's favorite toys and/or blankets

 

 

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