A. I can think ahead and plan ahead if at all possible.
B. I can call the police for help (911 where available). If a family member, partner or someone who takes care of me hits, kicks, punches, threatens or injures me in any way, it is a crime, even if this occurs in my home. It is a crime even if I do not have legal status in the United States.
C. If my batterer performs personal care tasks:
   · I can have my caretaker/partner help me out of bed early in the day. It is easier to respond to an emergency if I am mobile and alert.
   · I can make sure I have any mobility aids accessible. I can keep my cane or walker close by or be in my wheelchair.
   · I can stay close to a phone. I can keep a cordless or cellular phone with me, tuck it by my side in my wheelchair or on a walker or in a scooter basket. I can turn the ringer off so the abuser does not know I have it. I can program 911 and other safety numbers into the speed dial.
D. If I decide to leave, I will__________________________________. (I will practice ahead of time how to get out safely. I will visualize my escape route - what doors, windows, elevators, stairwells or fire escapes would I use?)
E. I can keep my purse/wallet and car keys ready and put them ______________________________ (place) in order to leave quickly.
F. I can tell __________________________ about the violence and request that they call the police if they hear suspicious noises coming from my house.
G. I can teach my children, grandchildren or other dependents how to use the telephone to contact the police and the fire department.
H. I will use ______________________ as my code word with my children or my friends so they can call for help. I will memorize or keep the phone number of a friend or neighbor I can call in a crisis.
I. If I have to leave my home, I will go to ______________________
________________. I will get out of an exit if possible or yell for help if it is safe to do so.
J. I can also teach some of these strategies to some/all of my children, grandchildren or other dependents.
K. 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.)
L. I will use my judgment and intuition. If the situation is very serious, I can give my abuser 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 women frequently leave the residence they share with the batterer. Leaving must be done strategically in order to increase safety. Batterers often strike back when they believe that a battered woman is leaving a relationship. It is important to be careful in selecting people you trust to help you. I can use some or all of the following safety strategies:

A. I will check with __________________and ____________________ to see who would be able to let me stay with them or lend me some money. I will think about whether I will go to the nearest shelter.
B. The hotline number for the domestic violence program in my area is _____________. I can seek shelter by calling this hotline. I can keep this number with me or memorize it. If I need an interpreter to communicate and the local program is unable to provide one, I can call the National Domestic Violence Hotline 1-800-799-SAFE (7233) or 1-800-787-3224 (TTY). I can call the program ahead of time to discuss safety planning, what my needs are and explain to them about my disability or special circumstance. If the program is inaccessible, I can ask them to give me the number of the nearest accessible program. Safety planning is very important at this time so I can ask the program to help me strategize.
C. I will change the payee on my SSI/SSDI benefits to _______________________(someone other than the batterer).
D. I will open a savings account to increase my independence (I will keep in mind that monthly bank statements may be sent out to my home address.) I will arrange to have my benefit check(s) direct deposited into this account.
E. If I have personal care needs, I will make plans for _________________ and ___________________and ___________________ to help with these needs when I am away from my batterer.
F. I will contact my caseworker (if I have one), ______________________ ________________, independent living center (if I have a disability) ________________, other disability office or support group ________________, or area council on aging ____________________ to find out about additional benefits or services I may be entitled to after leaving the batterer.
G. Other things I can do to increase my independence include: __________________________________________.
H. I can keep change for phone calls on me at all times or carry a cell phone. (Many domestic violence programs offer free cell phone programs for emergency use.) I understand 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.
I. I can make sure that my vehicle and any adaptations are in working order. I can keep the gas tank at least half full so I always have enough gas left if I need to leave in a hurry. If I cannot drive, I will arrange for _____________________ to take me to the safe place I have chosen.
J. If I need special transportation services and want to go to a support group, a counselor, a friend or flee for good, I will give the transit company the name of a place I regularly go (such as a medical appointment) ______________, but the address of where I really want to go (such as a counseling appointment) _________________________, so my batterer will not get suspicious. (If I am not currently using special transportation services and live in an area that offers it, I will consider applying. My doctor or caseworker can certify my disability.)
K. 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.
L. I will rehearse my escape plan and, as appropriate, practice it with my children, grandchildren or other dependents.

STEP 3: Safety in My Own Residence
There are many things a woman can do to increase her safety in her own residence. It may be impossible to do everything at once, but safety measures can be added step by step.

A. To make my house safe I can consider the following options:
a. I can change the locks on my doors and windows as soon as possible.
b. I can buy additional locks and safety devices to secure my windows.
c. I can also install or increase my outside lighting.
d. I can install smoke detectors and purchase fire extinguishers for each floor in my house/apartment.
B. I will teach my children/grandchildren how to use the telephone to make a collect call to me and to ___________________ (friend/ minister/other) in the event that my partner abducts the children/ grandchildren.
C. I will tell people who take care of my children/grandchildren which people have permission to pick up my children/grandchildren and that my abuser is not permitted to do so. The people I will inform about pick-up permission include:
__________________________ (school)
__________________________ (teacher/principal)
__________________________ (day care staff)
__________________________ (babysitter)
__________________________ (Sunday school teacher)
__________________________ (others)
__________________________ (others)
D. I can inform ______________________ (neighbor) _________________ (pastor ) _____________ (other) that my abuser no longer resides with me and they should call the police if he is observed near my residence.

STEP 4: Safety with a Protection Order
Many batterers obey protection orders, but one can never be sure which violent partners will obey and which will violate protection orders. Protection orders are available to all battered women, including battered immigrant women who do not have legal immigration status.

I recognize that I may need to ask the police and the courts to enforce my protection order. The following are some steps that I can take to help the enforcement of my protection order: (If I need help with any of these steps, I can call my local domestic violence program or attorney for assistance.)

A. I will keep my protection order _________________________(location).
B. I will give my protection order to police departments in the community where I work, in those communities where I usually visit family or friends, and the community where I live.
C. There should be a county registry of protection orders that all police departments can call to confirm the validity of a protection order. I can check to make sure that my order is in the registry. The telephone number for the county registry of protection orders is _____________.
D. For further safety, if I often visit other counties in ______ (state). I might file my protection order with the court in those counties. I will register my protection order in the following counties: __________________ and ___________________.
E. I will inform my employer, my minister, my closest friend, school, etc. _______________________ that I have a protection order in effect.
F. If my partner destroys my protection order, I can get another copy by going to ____________________located at ________________________.
G. 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. If the police do not respond right away, I can ________________________________ to keep safe.
H. If the police do not help, I can contact my advocate or attorney and will file a complaint with the chief of the police department.
I. I can also file a private criminal complaint with the judge in the jurisdiction where the violation occurred or with the prosecuting attorney. I can charge my battering partner with a violation of the protection order and all the crimes that he commits in violating the order.
J. For battered immigrants: If I am relying on my spouse to obtain legal immigration status, seeking help to stop domestic violence may also help me to obtain immigration status without the help of my spouse. I can consider filing for immigration relief under the Violence Against Women Act to obtain lawful permanent residency for myself and my children in the United States (if I am married to a U.S. citizen or lawful permanent resident). Anyone with immigration issues should contact a lawyer immediately. 

STEP 5: Safety on the Job and in Public
Each battered woman must decide if and when she will tell others that her partner has battered her and that she may be at continued risk. Friends, family and co-workers can help to protect women. Each woman should consider carefully which people to invite to help her safely. 

In my work or volunteer setting, I might do any or all of the following:

A. I can inform my supervisor, 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 can use different grocery stores and shopping malls to conduct my business and shop at hours that are different than those I used when residing with my battering partner.
G. I can also _________________________________________.

A. If I am going to consume, 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 consuming, I can _______________________
_____________________________________________________.
D. To safeguard my children/grandchildren, 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 make connections with people who give me spiritual support from my faith community.
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 to 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 ______________________________________.

STEP 8: Items to Take When Leaving
When women leave partners, it is important to take certain items with them. 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 best 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 take:

__ Identification for myself*
__ Children's/dependents' birth certificates*
__ My birth certificate*
__ Social Security cards*
__ School and vaccination records*
__ Money*
__ Checkbook, ATM card*
__ Credit cards*
__ Keys to house, car, office*
__ Driver's license and registration*
__ Medications, glasses, hearing aids, and other devices needed for me and my children, grandchildren and other dependents*
__ Welfare identification
__ Work permits
__ Green card
__ Passport(s)
__ Divorce and custody papers
__ Medical records - for all family members
__ Lease/rental agreement, house deed, mortgage payment book
__ Bank books
__ Insurance papers
__ Address book
__ Pictures
__ Jewelry
__ Children/grandchildren's favorite toys and/or blankets
__ Items of special sentimental value

__ I-94's
__ Photographs of wedding, wedding invitations, love letters from spouse, and family photographs
__ Papers that show you lived with your husband in the US (such as copies of the lease agreement, real property deed, utility bills, rent receipts, mortgage payment book) and evidence of current residence in the US
__ Other evidence of good faith marriage and joint residency, such as joint credit cards/bills, legal documents, insurance policies or magazine subscriptions with your name and your spouse's name, joint income tax returns or bank accounts, ticket stub receipts or pictures from vacations
__ Divorce papers from your previous marriage(s) or your spouse's previous marriage(s)
__ Copies of your spouse's birth certificate, social security card, green card or certificate of naturalization
__ Copies of any documents filed with INS

Telephone numbers I need to know:

Police department that responds to my home: _____________________
Police department that responds to my, my children's or my grandchildren's school: _________________________________________
Police department that responds to my work: _____________________
Battered women's program: ____________________________________
County registry of protection orders: ______________________________
Work number: ________________________________________________
After-hours work contact number: _______________________________
Faith leader: __________________________________________________
Other: ________________________________________________________
Witness/victim center: _________________________________________
Prosecutor's office: ____________________________________________
Local Center for Seniors: _______________________________________
Local Substance Abuse Center: __________________________________
Local Independent Living Center: _______________________________
Child/Adult Abuse Hotline: ____________________________________
Youth Hotline: _________________________________________________
National Domestic Violence Hotline: 1-800-799-SAFE (7233)
Refugee Hotline: 1-888-345-5898