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SAFETY PLAN WORKSHEET Step 1: During an episode of violence If I am in danger I can leave my house by___ and go to ___. If I cannot safely leave my house I can call 911 with my ___ (Cell Phone, TTYL
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How to fill out a safety planning worksheet

01
Start with basic information: Write your name, date, and contact information at the top of the worksheet.
02
Identify your risks: List potential situations that could pose a threat to your safety.
03
Develop safety goals: Write clear and achievable goals for what you want to accomplish with your safety plan.
04
Create a support network: Identify friends, family, or professionals who can help you in times of need.
05
Establish safety strategies: Outline specific actions you can take to enhance your overall safety (e.g., escaping, notifying authorities).
06
Plan emergency contacts: List important contacts, including local emergency services and trusted individuals.
07
Review and revise: Regularly go over the worksheet and update it as your situation or needs change.

Who needs a safety planning worksheet?

01
Individuals who have experienced or are at risk of abuse.
02
People living in potentially dangerous situations.
03
Survivors of trauma looking for a structured way to enhance their safety.
04
Anyone who feels unsafe and wants to take proactive measures.
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A safety planning worksheet is a document used to outline steps and strategies to enhance safety and preparedness in various situations, often used in contexts like disaster preparedness, workplace safety, or mental health support.
Typically, individuals or organizations involved in activities or environments that require risk management and safety protocols are required to file a safety planning worksheet. This may include business owners, employers, and certain public sector entities.
To fill out a safety planning worksheet, one should gather relevant information regarding potential risks, identify safety measures to be implemented, detail emergency contacts, and outline actionable steps to ensure preparedness for emergencies.
The purpose of a safety planning worksheet is to systematically identify potential dangers, establish preventative measures, and create a clear plan of action to mitigate risks, thereby ensuring a safer environment.
Information that must be reported on a safety planning worksheet typically includes identified hazards, safety protocols, emergency contacts, resources available for safety, and specific roles and responsibilities.
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