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This form is to be completed by the Principal Investigator/Activity Coordinator and submitted prior to a 'higher risk' off-campus activity as defined by the policy. It includes sections for planning,

How to fill out safety planning record

How to fill out Safety Planning Record

1. Gather all necessary information such as personal details, emergency contacts, and specific safety concerns.
2. Identify triggers that may lead to a safety risk and document them in the appropriate section.
3. Outline strategies and coping mechanisms to use when feeling unsafe or overwhelmed.
4. List resources and support systems, including contact information for local services or hotlines.
5. Review the document with a trusted individual for feedback and additional insights.
6. Keep the Safety Planning Record in a secure but accessible location.

Who needs Safety Planning Record?

1. Individuals facing potential safety risks, including those experiencing domestic violence, mental health crises, or substance abuse issues.
2. Caregivers or family members of individuals who may require safety planning.
3. Professionals in social work, counseling, or emergency services who assist clients with safety concerns.

People Also Ask about

Can anyone write a safety plan?

Yes. While this plan can be created on your own, working with a clinician or other mental health professional while building the safety plan can help you feel supported, add resources, and assist you in sticking to the plan.

What should a safety plan include?

A Safety Plan focusses on keeping you safe right now. A Safety Plan includes what you would do, and who might support you, in a crisis. They might include distraction techniques to help you get through the next seconds or minutes as thoughts of suicide becoming overwhelming, how you can make your immediate environment.

What is included in a safety plan pack?

A safety plan includes what and who might support you in a crisis; particularly when you are thinking about suicide. It may include techniques to distract you, what to do in an emergency and reminders of positive parts of your life you want to hold onto. Safety plans are brief and easy to read.

What does a safety plan include?

A safety plan is a set of steps you can take when you feel suicidal or are thinking about suicide. It includes your warning signs, coping strategies, and people to ask for support. You can write your own safety plan or use a free phone app. But it's best to work with a therapist to make your plan.

How do you write a safety plan?

Key steps of the Safety Plan Recognising warning signs and personal triggering events. Creating a safe environment. Identifying reasons to live. Things I can do by myself. Connecting with people and places. Reaching out to trusted family and friends in a crisis. Seeking professional support.

What are the three components of a safety plan?

3 Components of an Effective Safety Program Assessment. Control. Evaluation.

What is the meaning of safety planning?

A Safety Plan is a prioritized written list of coping strategies and sources of support patients can use who have been deemed to be at high risk for suicide. Patients can use these strategies before or during a suicidal crisis. The plan is brief, is in the patient's own words, and is easy to read.

What are the 6 steps of a safety plan?

6 Steps to Develop a Safety Plan Identify warning signs. Develop internal coping strategies. Identify people and social settings that provide distraction. Have a list of people you can ask for help. Make a list of professionals or agencies to contact during a crisis. How can I make my environment safe?

For pdfFiller’s FAQs

What is Safety Planning Record?

A Safety Planning Record is a document used to outline and track safety measures and protocols designed to protect individuals from potential harm or crisis situations.

Who is required to file Safety Planning Record?

Typically, social services agencies, mental health professionals, and organizations working with at-risk populations are required to file a Safety Planning Record.

How to fill out Safety Planning Record?

To fill out a Safety Planning Record, individuals should provide detailed information about the person at risk, potential triggers, support systems, emergency contacts, and specific strategies to ensure safety.

What is the purpose of Safety Planning Record?

The purpose of a Safety Planning Record is to create a proactive strategy for managing crises and ensuring the safety and well-being of individuals who may be in dangerous or challenging situations.

What information must be reported on Safety Planning Record?

The information required on a Safety Planning Record typically includes individual demographics, identified risks, coping strategies, emergency contacts, and resources available for support.