top of page

Safety Plan

What is a Safety Plan?

If you are in a situation of domestic violence, it may be helpful to create your own safety plan. Safety Plans enable you to plan ahead and may help you keep a clear mind when violence arises. Its a way to plan on ways to enhance your personal safety in case you decide to leave a violent situation. Please remember that domestic violence always involves a certain degree of danger and it is important to remain aware of that danger. 

Use the following safety planning worksheet to create a plan that works for you. If you need assistance call the Wesley Shelter at (252)291-2344 

Student Paper Writing

Safety Planning Worksheet

I can keep a bag ready and put it _____________ so I can leave quickly. 

I can tell ___________ about the violence and have them call the police when violence erupts. 

I will use this word code ____________ for my children, friends, or family to call for help. 

If I leave my phone I can go: ___________, ___________, ____________, or _____________. 

I will leave money and an extra set of keys with ____________.

I will open a savings account by (date)___________ to increase my independence. 

The domestic violence crisis line is _(____)____-_______

I will check with ________ and ________ to know who will let me stay with them or who will lend me money. 

I can leave extra clothes with ____________. 

I will review my safety plan every _________ (days/weeks/months) in order to plan the safest route. 

I will review the plan with _________ (a friend, counselor, or advocate)

I will teach my children to make collect calls to me and to ___________ if my partner tried to take them. 

I will tell people who are for my children who has permission to pick up my children. My partner is NOT allowed to. Inform the following people




Sunday School_________________________________



I can tell the following people that my partner no longer lives with me and that they should call the police if he nears my residence. Neighbor________________________________________

Church Leader ___________________________________


Prepare the following documents to bring with you. (If possible, make copies of them and leave them with friends or family you can trust.)

• Identification

• Birth certificates for me and my children

• Social Security cards

• School and medical records

• Driver’s license and registration

• Welfare identification

• Passport(s), Green Card(s), work permits

• Divorce papers

• Lease/rental agreement, house deed

• Mortgage payment book, current unpaid bills

• Insurance papers

Additional items you may want to bring with you:

•  Address book

•  Pictures, jewelry, items of sentimental value

•  Children’s favorite toys and/or blankets

•   Money, bankbooks, credit cards

•  Keys – house/car/office

•  Medications

•  Change of clothes

What do I do next ?

Wesley Shelter is dedicated to providing the answers and support you need. Call our main crisis line at 252-291-2344 for anonymous help or advice.

bottom of page