Safety Plan


Important Information:

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 _______________________.

When 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).


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.

Phone Numbers:

Police: _____________________

Hotine: _____________________

Friends: ____________________

Shelter: ____________________


Items to Take Checklist


*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


*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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