Safety Planning Checklist

Before You Are Ready To Leave:

___ Establish a verbal code word with family and friends to identify when you are in trouble

___ Ask a neighbor to call the police if violence beings

___ Hide any weapons, if safe

___ Arrange for safety/care of pets


Pack an “Escape Bag” with:

___ Driver’s License or photo identification

___ Birth Certificates for you and your children

___ Social Security cards for you and your children

___ EBT card, Medicaid, insurance cards, and Financial Information

___ Checkbook, ATM card, etc.

___ Money, credit cards, bank books, etc.

___ Proof of income for self and partner


Legal Papers To Have With You:

___ Your Injunction for Protection (if you have one)

___ Lease, rental agreement, house deed

___ Car registration and insurance papers

___ Health and life insurance papers

___ Medical records for you & your children

___ Immigration papers


Other Important Items:

___ Names and addresses of family members

___ House, car and safety deposit box keys

___ Medicines and all prescriptions (extra)

___ Jewelry, glasses, dentures, contact lenses

___ Pictures of you, your children and your abusive partner

___ Change of clothes for you and your children (diaper bag, bottles, etc.)

___ Security blanket, favorite book and toy for your child