Recovery For Abused Women

“Empowering the abused woman to recover with God's truth"

Personal Safety Plan for Victims of Domestic Violence and Abuse

The Lula McGrady Foundation, Inc.                                                                                  

P.O. Box 490562                        

Leesburg, FL 34749-0562     

352.406.2209 - Office – Email - Web site                                      




Personal Safety Plan


Please answer the questions below to develop your own safety plan. Let us know if you would like a copy of your plan.


 Client Name:_________________________________________________ Date:_______________________________


 1. If I decide to leave, I will________________________________________________.


2. I can keep a bag ready and put it______________________ so I can leave quickly.

3. I can tell________________________________about the violence for them call the police when

    violence erupts.


4. I will leave money and an extra set of keys with___________________________________________.

5. I will keep important documents and keys at___________________________________________________.

6. The domestic violence hotline is _____________________.

7. The shelter's hotline is _________________________.

8. I will rehearse the escape plan and practice it with my children.

9. I can change the locks on my doors and windows as soon as possible.

10. I will teach my children how to use the phone to make collect calls to me and to  

         ___________________________ (friend, family, minister) if my partner tried to take them.

11. I will tell the people who care for my children, who have permission to pick them

      up.  My  partner is NOT allowed to pick them up. Inform the following people:







 12. I can tell my the following people that my partner no longer lives with me and that

       they  should call  the police if he is near my residence:






13. I can call the local domestic violence agency if I am not sure how to register my

       protection order with the police departments.


14. If my protection order gets destroyed, I know I can go to the County Courthouse and

       get another copy.


15. I can tell my boss, security, and ____________________________ at work about this situation.


16. I can ask___________________________________ to help screen my phone calls.


17. When leaving work I can do the following:    





18. When I am driving home from work and problems arise, I






19. If I use public transportation, I can________________________________________




20. If I feel depressed and ready to return to a potentially violent situation/ partner, I can call__________________________________________________________________________



Client Signature:______________________________________________ Date:____________________________


Jesus loves YOU! You are not alone!

Views: 18


You need to be a member of Recovery For Abused Women to add comments!

Join Recovery For Abused Women

© 2019   Created by Dr. Dorothy E. Hooks, PsyD.   Powered by

Report an Issue  |  Terms of Service

By: Twitter Buttons