Our Family Safety Plan Template printable pdf download

Our Family Safety Plan Template

OUR FAMILY SAFETY PLAN

This is a draft family safety plan which may be adapted by

domestic violence programs. It includes some basic

elements of joint safety planning for battered women and

their children. This version may be too long for some

children, but it also omits other important elements that

some domestic violence programs may want to include.

Some examples are planning for safety at school, child care

or visitation exchanges, and safety procedures in case of fire

or in the presence of weapons. Domestic violence programs

may use this draft to create their own family safety planning

form, which may be further adapted to meet the needs of

individual families.

Our names:

Mother: _________________________________________

Children: ________________________________________

________________________________________________

Safe people kids in our family can talk to or call when there

is trouble:

1. ________________________ Phone________________

2. ________________________ Phone________________

3. ________________________ Phone________________

4. ________________________ Phone________________

5. ________________________ Phone________________

Our family uses a signal when there is trouble. Our family

signal is

______________________________________________.

When we see or hear the signal, the children will

________________________________________________

Our Family Safety Plan Template