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Named: _____________________________

Date: _______________________________

Review dates: ________________________

________________________

________________________

PERSONALIZED SAFETY PLAN

The following steps represent my plan for increasing my safety and preparing in advance for the possibility for further violence.  Although I do not have control over my partner’s violence, I do have a choice about how to respond to him/her and how to best get myself and my children to safety.

Step 1: Safety during a violent incident.  Women cannot always avoid violent incidents.  In order to increase safety, battered women may use a variety of strategies.

I can use some or all of the following strategies:

A.If I decide to leave, I will ____________________________-.  (Practice how to get out safely.  What doors, windows, elevators, stairwells or fire escapes would you use?)

B.I can keep my purse and car keys ready and put them (place) ____________________ in order to leave quickly.

C.I can tell _________________________________ about the violence and request they call the police if they hear suspicious noises coming from my house.

I can also tell ____________________________ about the violence and request they call the police if they hear suspicious noses coming from my house.

D.I can teach my children how to use the telephone to contact the police and the fire department.

E.I will use ____________________________ as my code word with my children or my friends so they can call for help.

F.If I have to leave my home, I will go ________________________________.  (Decide this even if you don’t think there will be a next time.)

If I cannot go to the location above, then I can go to ______________________________ or ______________________________.

G.I can also teach some of these strategies to some/all of my children.

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