Separation
Safety Plan
Name:_______________________
Date:____________
Complaint #:___________ Officer:
Net______________
The following steps represent my plan for
increasing my safety and preparing in advance for the possibility for further
violence. Although I do not have control over my partner's violence, I do have a
choice about how to respond to him/her and how to best get myself and
my children to safety.
Step 1: Safety during a violent incident.
Victims cannot always avoid violent incidents. In order to increase safety,
battered victims may use a variety of strategies.
I can use some or all of the following
strategies:
A. If I decide to leave, I will
___________________. (Practice how to get out safely. What doors, windows,
elevators, stairwells or fire escapes would you use?)
B. I can keep my money and car keys ready and put them (place) _________________
in order to leave quickly.
C. I can tell _____________________about the violence and request they call the
police if they hear suspicious noises coming from my house.
D. I can teach my children how to use the telephone to contact the police and
the fire department.
E. I will use _______________________ as my code for my children or my friends
so they can call for help.
F. If I have to leave my home, I will go _____________________ (Decide this even
if you don't think there will be a next time).
If I cannot go to the location above, then I
can go to_________ __________________or ______________________________.
G. I can also teach some of these strategies to
some/all my children.
H. When I expect we are going to have an argument, I will try to move to a space
that is lowest risk, such as ____________ ____________________. (Try to avoid
arguments in the bathroom, garage, kitchen, near weapons or in rooms without
access to an outside door).
I. I will use my judgment and intuition. If the situation is very serious, I can
give my partner what he/she wants to calm him/her down. I have to protect myself
until I/we are out of danger.
Step 2: Safety when preparing to leave.
Battered victims frequently leave the residence they share with the battering
partner. Leaving must be done with a careful plan in order to increase safety.
Batterers often strike back when they believe that a battered victim is leaving
the relationship.
I can use some or all the following safety
strategies:
A. I will leave money and an extra set of keys
with _____________ so that I can leave quickly.
B. I will keep copies of important documents or keys at _______________________.
C. I will open a savings account by ______________, to increase my independence.
D. Other things I can do to increase my independence include:
E. The domestic violence program's hot line number is 297-8833 (Metro Police
Domestic Violence -880-3000) and I can seek shelter by calling
this hot line.
F. I can keep change for phone calls on me at all times. I under stand that if I
use my telephone credit card, the following month the telephone bill will tell
my batterer those numbers that I called after I left. To keep my telephone
communications confidential, I must either use coins or I might get a friend to
permit me to use their telephone credit card for a limited time when I first
leave.
G. I will check with ____________________ and _____________ to see who would be
able to let me stay with them or lend me some money.
H. I can leave extra clothes with _________________________.
I. I will sit down and review my safety plan every ______________ in order to
plan the safest way to leave the residence. _____________ (domestic violence
advocate or friend) has agreed to help me review this plan.
J. I will rehearse my escape plan and, as appropriate, practice it with my
children.
Step 3: Safety in my own residence. There
are many things that a victim can do to increase her/his safety in their own
residence. It may be impossible to do everything at once, but safety measures
can be added step by step.
Safety measures I can use include:
A. I can change the locks on my doors and windows
as soon as possible.
B. I can replace wooden doors with steel/metal doors.
C. I can install security systems including additional locks, window bars, poles
to wedge against doors, an electronic system, etc.
D. I can purchase rope ladders to be used for escape from second floor windows.
E. I can install smoke detectors and purchase fire extinguishers for each floor
in my house/apartment.
F. I can install an outside lighting system that lights up when a person is
coming close to my house.
G. I will teach my children how to use the telephone to make a collect call to
me and to _______________(friend/minister/ other) in the event that my partner
takes the children.
H. I will tell people who take care of my children which people have permission
to pick up my children and that my partner is not permitted to do so. The people
I will inform about pick-up permission include:
__________________________________________(school),
________________________________________(day care staff),
________________________________________(babysitter),
___________________________________(Sunday school teacher),
________________________________________(teacher),
________________________________________(and),
________________________________________(others),
I. I can inform ______________________________(neighbors),
_______________________________________(pastor), and,
_______________________________________(friend) that my partner no longer
resides with me and they should call the police if he is observed near my
residence.
I can find out my risks
with
Rate Your Risk
Tests.
Step 4: Safety with an Order of
Protection. Many battered victims obey protection orders, but one can
never be sure which violent partner will obey and which will violate protection
orders. I recognize that I may need to ask the police and the court to enforce
my protection order.
The following are some steps that I can take to
help the enforcement of my protection order:
A. I will keep my protection order
_________________(location) (Always keep it on or near your person).
B. I will give my protection order to police departments in the communities
where I usually visit family or friends, and
in the community where I live.
C. There should be a county registry of protection orders that all police
departments can call to confirm a protection order. I can check to make sure
that my order is in registry. The telephone number for the county registry of
protection order is _________________________________.
D. For further safety, if I often visit other counties in Tennessee, I might
file my protection order with the court in those counties. I will register my
protection order in the following counties:
___________________ and _________________ that
I have a protection order in effect.
E. I can call the local domestic violence program
if I am not sure about B, C, or D above or if I have some problem with my
protection order.
F. I will inform my employer, my minister, my closest friend and _____________
and ____________that I have a protection order in effect.
G. If my partner destroys my protection order, I can get another copy from the
Davidson County Courthouse by going to the Circuit Court Clerk's office on the
5th floor.
H. If my partner violates the protection order, I can call the police and report
a violation, contact my attorney, call my advocate, and/or advise the court of
the violation.
I. If the police do no help, I can contact my advocate or attorney and will file
a complaint with the chief of the police department.
J. I can also file a private criminal compliant with the district justice in the
jurisdiction where the violation occurred or with the district attorney. I can
charge my battering partner with a violation of the Order of Protection and all
the crimes that he/she commits in violating the order. I can call the domestic
violence advocate to help me with this.
Step 5: Safety on the job and in public.
Each battered victim must decide if and when he/she will tell others that their
partner has battered them and that he/she may be at continued risk. Friends,
family and co-workers can help to protect victims. Each victim should consider
carefully which people to invite to help secure his/her safety.
I might do any or all of the following:
A. I can inform my boss, the security supervisor
and ___________ at work of my situation.
B. I can ask ________________ to help screen my telephone calls at work.
C. When leaving work, I can ______________________________
_________________________________________________.
D. When driving home if problems occur, I can ________________
_________________________________________________.
E. If I use public transit, I can ______________________________
_________________________________________________.
F. I will go to different grocery stores and shopping malls to conduct my
business and shop at hours that are different than those when residing with my
battered partner.
G. I can use a different bank and take care of my banking at hours different
from those I used when residing with my battered partner.
H. I can also __________________________________________.
Step 6: Safety and drug or alcohol use.
Most people in this culture use alcohol. Many use mood-altering drugs. Much of
this use is legal and some is not. The legal outcomes of using illegal drugs can
be very hard on a battered victim, may hurt his/her relationship with their
children and put him/her at a disadvantage in other legal actions with the
battering partner. Therefore, victims should carefully consider the potential
cost of the use of illegal drugs. But beyond this, the use of any alcohol or
other drug can reduce a victim's awareness and ability to act quickly to protect
themselves from the battering partner. Furthermore, the use of alcohol or other
drugs by the batterer may give him/her an excuse to use violence. Therefore, in
the context of drug or alcohol use, a victim needs to make specific safety
plans.
If drug or alcohol use has occurred in my
relationship with the battering partner, I can enhance my safety by some or all
of the following:
A. If I am going to use, I can do so in a safe
place and with people who understand the risk of violence and are committed to
my safety.
B. I can also ___________________________________________.
C. If my partner is using, I can _____________________________.
D. I might also _________________________________________.
E. To safeguard my children, I might ________________________
and ______________________________________________.
Step 7: Safety and my emotional health.
The experience of being battered and verbally degraded by partners is usually
exhausting and emotionally draining. The process of building a new life for
myself takes much courage and incredible energy.
To conserve my emotional energy and resources and
to avoid hard emotional times, I can do some of the following:
A. If I feel down and ready to return to a
potentially abusive situation, I can
_____________________________________________.
B. When I have to communicate with my partner in person or by telephone, I can
____________________________________.
C. I can try to use "I can . . . " statements with myself and to be
assertive with others.
D. I can tell myself - "_____________________________________
______________________________" whenever I feel others are trying to
control or abuse me.
E. I can read ____________________________to help me feel stronger.
F. I can call ___________________, ___________________ and _________________as
other resources to be of support of me.
G. Other things I can do to help me feel stronger are ____________
______________, and _______________________________.
H. I can attend workshops and support groups at the domestic violence program or
_________________________, or _____ _______________to gain support and
strengthen my relationship with other people.
Step 8: Items to take when leaving.
When victims leave partners, it is important to take certain items with them.
Beyond this, victims sometimes give an extra copy of papers and an extra set of
clothing to a friend just in case they have to leave quickly.
Money : Even if I have never
worked, I can legally take 1/2 of the funds in the checking and savings accounts
as Tennessee is a community property state. If I don't take any money from the
accounts, he/she can legally take all money and/or close the account and I may
not get my share until the court rules on it if ever.
Items with asterisks on the following list are
the most important to take. If there is time, the other items might be taken, or
stored outside the home.
These items might be placed in one location, so
that if we have to leave in a hurry, I can grab them quickly.
When I leave, I should have:
* Identification for myself
* Children's birth certificate
* My birth certificate
* Social security cards
* School and vaccination records
* Money
* Checkbook, ATM (Automatic Tellers Machine) card
* Credit cards
* Keys - house/car/office
* Driver's license and registration
* Medication
* Welfare identification, work permits, Green card
* Passport(s), Divorce papers
* Medical records - for all family members
* Lease/rental agreement, house deed, mortgage payment book
* Bank books, Insurance papers
* Small saleable objects
* Address book
* Pictures, jewelry
* Children's favorite toys and/or blankets
* Items of special sentimental value
Telephone numbers I need to know:
Police department - home - 911
Metro Domestic Violence Division - 880-3000
Nashville District Attorney General's Office - 862-5500
Police department - school _____________________________
Police department - work ______________________________
Battered victims program - 297-8833 (Nashville) __________
County registry of protection orders ______________________
Work number________________________________________
Supervisor's home number_____________________________
Minister____________________________________________
Other______________________________________________
I will keep this document in a safe place
and out of the reach of my potential attacker.
Review date:_________________________
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