Courtesy of Vera House

PERSONAL SAFETY PLAN

FOR 24 HOUR SUPPORT I CAN

CALL VERA HOUSE AT (315) 468-3260

Don't delay! Print and complete this form. Advocates at Vera House can assist you in completing this plan.

When a crisis arises in an abusive relationship, there is little time to plan how to safely leave if you need to. Although you do not have control over your partner’s violence, you do have a choice about how to respond to him/her and how best to get yourself and your children to safety. If you are currently in an abusive situation, you can increase your safety by considering the following:

ü If an argument turns violent when we are at home, I will try to move to an area of low risk (when possible, avoid altercations in the kitchen/bathroom due to the availability of weapons).

ü I will have important phone numbers accessible to myself and my children (These numbers are listed on the back).

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

ü I can teach my children how to use the phone to call the police and fire department.

ü I can teach my children how to make a collect call to

______________________ (friend/clergy/other) in case my partner takes them from me.

ü I can tell ______________ and ______________ about the violence and tell them to call police if they hear suspicious noises coming from my home.

ü If I leave my home I can go to: (neighbors/friends/family)

**Decide this even if you don’t think there will be a next time**

ü _____________________________________________________________

ü I can leave extra money, car keys, clothes and copies of important documents with:

_____________________________________________________________

Other ways I can keep safe are:

_______________________________________________________________________

_____________________________________________________________

To increase safety and independence, I can: keep change for phone calls or a phone card with me at all times, open my own savings account, rehearse my escape routes with my children and support person and review this safety plan weekly.

You may be eligible for a free cell phone connected to 911 and the shelter. Ask a Vera House staff person for details.

Important Phone Numbers

POLICE

FRIENDS

SHELTER

HOTLINE

WORK

SUPERVISOR’S HOME PHONE

CLERGY

SCHOOL

OTHER

CHECKLIST ITEMS TO TAKE:

n Identification (e.g. birth certificates, SS cards, drivers license, benefit card, photo ID, passport, green card)

n School and Medical records

n Money, bank book, credit card, ATM

n Keys (House, car, office)

n Car registration

n Medication for self and children

n Address Book

n Insurance papers

n Court Documents (Custody, Order of Protection)

n Marriage Certificate

n Tax Returns

n Divorce Papers

n Sentimental Items (Photos, jewelry etc.)

n Lease/Rental Agreement

n House Deed, mortgage payment book

n Current unpaid bills

n Children’s toys/blankets

n Small saleable objects

Try to place these things in one package and hide to grab quickly if needed or give to a friend or relative.

INCREASING SAFETY WHEN YOU LEAVE THE RELATIONSHIP

I will tell ____________ and ____________ that my partner no longer resides with me and to call the police if he/she is observed near my residence or my children.

I can change the locks, install metal doors, a security system (you may be eligible for a free security system, check with your DV advocate), smoke/CO2 detectors, fire extinguishers, rope ladders and an outdoor lighting system with motion detectors.
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:
________________________________________________
I can obtain a protective order from _______________ court, keep it on or near me at all times and leave copies with ________________
I will leave copies of court orders i.e. custody and orders of protection, at my children’s schools and child care providers.
If I feel down and considering returning to an abusive situation, I can call ______________________ for support or attend support groups and workshops to gain support and strengthen my relationships with other people.
Take new routes to work, stores, friends, relatives etc.-try not to be “predictable”.

IF I AM BEING FOLLOWED ON THE HIGHWAY SOME THINGS I CAN DO ARE:

ü Go to the nearest police station.

ü Flash my lights and blow my horn at fellow motorists.

ü Yell for help out the car windows.

ü Buy a “Call the Police” banner and display it in the back windshield or in my car windows.

ü Drive to any public area where there are a lot of people.

ü Stay on heavily traveled roads.

ü Stay in well lit areas.

SAFETY WITH A PROTECTION ORDER

Many batterers obey protection orders (O/P) but one can never be sure which violent partner will obey and which will violate orders of protection. I realize that I may need the police and the courts to enforce my order.

The following are some steps I can take to help the enforcement of the order:

I will keep my O/P (location) ___________________________

(Always keep it on or near your person. If you change purses, that’s the first thing that should go in.)

I will give a copy of my protection order to law enforcement agencies in the community where I work, where family and friends reside and I visit frequently and in the community where I live.
I can call my DV advocate if I need help with the enforcement of my O/P.
If my partner destroys the O/P I can obtain a new copy from the court-my DV advocate can help me.
If my partner violates the O/P I can call the police (911), contact my attorney, notify the court of the violation and call my DV advocate.

I can also: _____________________________________________________

SAFETY AT WORK AND IN PUBLIC

I must decide if and when I will tell others about my situation and that I may be at continued risk. Friends, family and co-workers may help to protect me. I should consider carefully which people I confide in to help me.

I might do any and/or all of the following:

ü I can inform my boss, the security supervisor and __________________ at work about my situation

ü I can tell __________________ and __________________ at work about my situation and ask them to screen my calls.

ü When leaving work, I can

_________________________________________

ü If I use public transportation I can

_________________________________________________________

ü ü When driving home if problems occur I can

________________________________________________________

ü I can use different grocery stores, banks and shopping malls to conduct my business and shop at hours that are different from those when residing with my partner.

ü ü I can also:

________________________________________________________

SAFETY AND MY EMOTIONAL HEALTH

The experience of being battered and verbally degraded by a partner is exhausting and emotionally draining. The process of building a new life for myself takes courage and energy.

To preserve my emotional strength and resources and to avoid overloading my emotional reserves, I can do some of the following:

ü If I feel down and ready to give up and return to an abusive situation I will

________________________________________________________

ü When I have to communicate with my former partner in person or by phone, I can

________________________________________________________

ü I will try to use “I can...” statements with myself and to be assertive with others.

ü I can tell myself : “___________________________________________” whenever others try to abuse or control me.

ü I can read __________________________________ to help me feel stronger.

ü I can call ____________________ and ____________________ and any others who will be supportive of me.

ü Other things I can do to help me feel stronger are:

________________________________________________________

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