Name:_____________________ Date:_______________________
Law Enforcement Complaint # _____________________
Officers Name: ___________________________

The following steps represent my plan for increasing my safety and preparing in advance for the possibility of further violence. Although I do not have control over my partner's violence, I do have a choice about how to respond to her/him and how to best get myself and/or 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 all or some of the strategies:

1. If I decide to leave, I will __________________________________

2. Practice how to get out safely. (What doors, windows, elevators, stairwells, or fire escapes would I use?)

3. I can keep my purse and car keys ready and put them (place) ___________________________ in order to leave quickly

4. I can tell ____________________ about the violence and request they call the police if they hear any suspicious noises coming from my house or apartment

5. I can teach my children how to use the telephone to contact the police, fire, and emergency number: 911.

6. I will use __________________________ as my code for my children or my friends so they can call for help.

7. If I have to leave my home, I will go to __________________________________ (decide this even if I don't think there will be a next time)

8. If I cannot go to the location above, then I can go to ______________________________ or ________________________________________________________________

9. I can also teach some of these strategies to some/all of my children ___________________________________________________________________________
___________________________________________________________________________

10. When I expect we are going to have an argument, I will try to move to a space that is a low risk area, such as ___________________________________________________ (try to avoid arguments in bathroom, garage, kitchen, near weapons, or in rooms without access to an outside door)

11. 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 and/or my children until I/we are out of danger.