Printable safety plan for individuals experiencing domestic violence, outlining strategies for immediate and long-term safety.

Thank you for uploading the image. It shows a “Domestic Violence Personalized Safety Plan” worksheet, designed to help individuals create a customized safety strategy if they are experiencing or at risk of domestic violence.

Since this is a *personalized* safety plan, I cannot fill it out for you — because it requires your personal experiences, resources, relationships, and environment. However, I can help you understand how to complete each step, what each question means, and provide guidance on making thoughtful, realistic choices.

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## 📄 OVERVIEW OF THE WORKSHEET

This safety plan has two main steps:

✔ STEP 1: Safety during a violence incident

> *“Women cannot always avoid violent incidents. In order to increase safety, battered women may use a variety of strategies.”*

This section helps you identify what you can do in the moment when violence is happening or about to happen — to protect yourself and your children.

✔ STEP 2: Safety when preparing to leave

> *“Battered women frequently leave the residence they share with the battering partner… Leaving may be done with a careful plan in order to increase safety.”*

This section helps you prepare to leave safely — whether temporarily or permanently — including planning for shelter, documents, finances, and emotional support.

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## 🔍 DETAILED EXPLANATION & HOW TO COMPLETE EACH SECTION

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🚨 STEP 1: SAFETY DURING A VIOLENCE INCIDENT

You’re asked to choose from options A–J (or add your own) based on what’s realistic and safe for you.

#### A. If I decide to leave, I will...
→ Think: Where will you go? Who can you call? What route will you take?
✔ Example: “I will go to my sister’s house, which is 10 minutes away, and I’ve already packed a bag with essentials.”

#### B. Practice how to get out safely. When door, window, elevators, stairwells, or fire escapes could be used...
→ Identify all possible escape routes from your home/apartment. Test them.
✔ Example: “The back window leads to a fire escape — I’ve checked it’s unlocked and clear.”

#### C. I can keep my purse and/or keys ready and put them (freedom) in order to leave quickly.
→ Keep emergency items (keys, phone, ID, cash) hidden but accessible.
✔ Tip: Use a “go-bag” or stash items in a trusted friend’s car or under a loose floorboard.

#### D. I can call the police or an abuse specialist... request that she/he call the police if I am in danger.
→ Know local hotlines and police non-emergency numbers. Consider using a code word with a trusted person.
✔ Example: “My neighbor knows to call 911 if I say ‘the flowers need watering.’”

#### E. I can teach my children how to use the telephone to contact the police, the fire department, and 911.
→ Teach kids their full name, address, and emergency numbers. Role-play calling 911.
✔ Tip: Write down numbers on a card they can carry.

#### F. I will use __________ as my code with my children if I need to leave or call for help.
→ Create a secret signal or phrase only you and your kids know.
✔ Example: “If I say ‘let’s go see Grandma,’ that means we leave NOW.”

#### G. I have also made some of these strategies to some or all of my children.
→ Share age-appropriate safety plans with your kids. Empower them without scaring them.
✔ Example: “My 8-year-old knows to hide in the closet and call 911 if Dad gets angry.”

#### H. When I expect we’re going to have an argument, I’ll try to stay in a place that is low risk...
→ Avoid kitchens (knives), bathrooms (locked doors), or rooms with weapons.
✔ Example: “I’ll stay in the living room near the front door where I can exit easily.”

#### I. I will use my judgment and intuition. If the situation is very violent, I can try to part when he/she wants to calm down first. I have to protect myself until I am out of danger.
→ Trust your gut. Don’t stay to “fix” things if you feel unsafe.
✔ Reminder: You don’t owe anyone your safety — even if they promise to change.

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🚪 STEP 2: SAFETY WHEN PREPARING TO LEAVE

This is about planning your exit — not just physically, but emotionally and logistically.

> *“Leaving may be done with a careful plan in order to increase safety.”*

#### 💡 Key areas to consider:
- Where will you go? (Shelter, family, friend’s house)
- What documents do you need? (ID, birth certificates, social security cards, lease, bank info)
- How will you get there? (Transportation, ride-share, bus, walking)
- Who can help you? (Supportive friends, counselors, legal aid, DV organizations)
- What will you tell your children? (Age-appropriate explanation)
- How will you handle money? (Emergency fund, hidden cash, access to bank account)

#### ✍️ Fill-in-the-blank prompts (not fully visible in image, but implied):
You may be asked to list:
- Emergency contacts
- Important documents to gather
- Safe places to go
- How you’ll communicate with kids
- Legal steps (restraining orders, custody plans)

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## 🛡️ ADDITIONAL SAFETY TIPS (NOT ON FORM BUT CRITICAL)

1. Change passwords on email, social media, and banking apps.
2. Use a burner phone if your partner monitors your devices.
3. Document abuse: Save texts, voicemails, photos of injuries, medical records.
4. Contact a local domestic violence agency — they offer free counseling, shelters, legal help, and safety planning.
- U.S.: National Domestic Violence Hotline — 1-800-799-7233 or text START to 88788
- Other countries: Search “domestic violence hotline [your country]”

5. Create a digital safety plan: Clear browser history, use private browsing, remove location sharing.

6. Tell someone you trust — a coworker, teacher, doctor, pastor — so they can help if needed.

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## ⚠️ IMPORTANT REMINDERS

- You are not alone. Millions of people experience domestic violence — help is available.
- You are not to blame. Abuse is never your fault.
- Leaving is dangerous — plan carefully. Most violence escalates when someone tries to leave.
- It’s okay to take small steps. Safety doesn’t have to mean leaving immediately — it can mean creating boundaries, hiding money, or calling a hotline.

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## 🧭 NEXT STEPS FOR YOU

Since this is a personalized form, here’s what you should do now:

1. Print or download this form (if you haven’t already).
2. Grab a pen and quiet space — answer honestly, even if it’s scary.
3. Choose 3–5 strategies from Step 1 that feel most realistic and safe for you right now.
4. Start Step 2 by listing:
- One safe place you could go
- One person you can call for help
- One document you need to gather
5. Reach out to a professional — call a domestic violence hotline or visit a local shelter website.

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## 📞 EMERGENCY RESOURCES (U.S.)

- National Domestic Violence Hotline:
📞 1-800-799-7233
💬 Text “START” to 88788
🌐 www.thehotline.org

- National Dating Abuse Helpline (for teens):
📞 1-866-331-9474
💬 Text “LOVEIS” to 22522

- Local Shelters: Search “domestic violence shelter near me”

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## ❤️ FINAL NOTE

You’re taking a brave step by seeking help. Even filling out this form is an act of self-protection. Be gentle with yourself. Your safety matters more than anything else.

If you’d like, you can reply with your answers (as much or as little as you’re comfortable sharing), and I can help you review them for safety and effectiveness — or help you find local resources.

You deserve to live free from fear.

You are not alone.

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Let me know if you want:
- A printable version of this form
- Help finding local shelters or legal aid
- Guidance on talking to your children about safety
- Emotional support or encouragement

I’m here for you.