Separation Safety Plan
Complaint #:___________ Officer: _________________
The following steps represent my plan for increasing my safety
and preparing in advance for the possibility for further violence. Although
I do not have control over my partner's violence, I do have a choice about
how to respond to him/her and how to best get myself and my children
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 some or all of the following strategies:
- If I decide to leave, I will ___________________. (Practice how to
get out safely. What doors, windows, elevators, stairwells or fire escapes
would you use?)
- I can keep my money and car keys ready and put them (place) _________________
in order to leave quickly.
- I can tell _____________________about the violence and request they
call the police if they hear suspicious noises coming from my house.
- I can teach my children how to use the telephone to contact the police
and the fire department.
- I will use _______________________ as my code for my children or my
friends so they can call for help.
- If I have to leave my home, I will go _____________________ (Decide
this even if you don't think there will be a next time).
If I cannot go to the location above, then I can go to___________________________or
- I can also teach some of these strategies to some/all my children.
- 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).
- 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 until I/we are out of danger.
Step 2: Safety when preparing to leave. Battered victims
frequently leave the residence they share with the battering partner.
Leaving must be done with a careful plan in order to increase safety.
Batterers often strike back when they believe that a battered victim is
leaving the relationship.
I can use some or all the following safety strategies:
- I will leave money and an extra set of keys with _____________ so
that I can leave quickly.
- I will keep copies of important documents or keys at _______________________.
- I will open a savings account by ______________, to increase my independence.
- Other things I can do to increase my independence include:
- The domestic violence program's hot line number is (615) 297-8833 (Metro
Police Domestic Violence - (615) 880-3000) and I can seek
shelter by calling this hot line.
- I can keep change for phone calls on me at all times. I under stand
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 will check with ____________________ and _____________ to see who
would be able to let me stay with them or lend me some money.
- I can leave extra clothes with _________________________.
- 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.
- I will rehearse my escape plan and, as appropriate, practice it with
Step 3: Safety in my own residence. There are many things
that a victim can do to increase her/his safety in their own residence.
It may be impossible to do everything at once, but safety measures can
be added step by step.
Safety measures I can use include:
- I can change the locks on my doors and windows as soon as possible.
- I can replace wooden doors with steel/metal doors.
- I can install security systems including additional locks, window
bars, poles to wedge against doors, an electronic system, etc.
- I can purchase rope ladders to be used for escape from second floor
- I can install smoke detectors and purchase fire extinguishers for
each floor in my house/apartment.
- I can install an outside lighting system that lights up when a person
is coming close to my house.
- I will teach my children how to use the telephone to make a collect
call to me and to _______________(friend/minister/ other) in the event
that my partner takes the children.
- I will tell people who take care of my children which people have
permission to pick up my children and that my partner is not permitted
to do so. The people I will inform about pick-up permission include:
________________________________________(day care staff),
___________________________________(Sunday school teacher),
- I can inform ______________________________(neighbors), _______________________________________(pastor),
and, _______________________________________(friend) that my partner
no longer resides with me and they should call the police if he is observed
near my residence.
Step 4: Safety with an Order of Protection. Many battered
victims obey protection orders, but one can never be sure which violent
partner will obey and which will violate protection orders. I recognize
that I may need to ask the police and the court to enforce my protection
The following are some steps that I can take to help the enforcement
of my protection order:
- I will keep my protection order _________________(location) (Always
keep it on or near your person).
- I will give my protection order to police departments in the communities
where I usually visit family or friends, and in the community where
- There should be a county registry of protection orders that all police
departments can call to confirm a protection order. I can check to make
sure that my order is in registry. The telephone number for the county
registry of protection order is _________________________________.
- For further safety, if I often visit other counties in Tennessee,
I might file my protection order with the court in those counties. I
will register my protection order in the following counties:
___________________ and _________________ that I have a protection
order in effect.
- I can call the local domestic violence program if I am not sure about
B, C, or D above or if I have some problem with my protection order.
- I will inform my employer, my minister, my closest friend and _____________
and ____________that I have a protection order in effect.
- If my partner destroys my protection order, I can get another copy
from the Davidson County Courthouse by going to the Circuit Court Clerk's
office on the 5th floor.
- 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 no help, I can contact my advocate or attorney and
will file a complaint with the chief of the police department.
- I can also file a private criminal compliant with the district justice
in the jurisdiction where the violation occurred or with the district
attorney. I can charge my battering partner with a violation of the
Order of Protection and all the crimes that he/she commits in violating
the order. I can call the domestic violence advocate to help me with
Step 5: Safety on the job and in public. Each battered
victim must decide if and when he/she will tell others that their partner
has battered them and that he/she may be at continued risk. Friends, family
and co-workers can help to protect victims. Each victim should consider
carefully which people to invite to help secure his/her safety.
I might do any or all of the following:
- I can inform my boss, the security supervisor and ___________ at work
of my situation.
- I can ask ________________ to help screen my telephone calls at work.
- When leaving work, I can _____________________________________ __________________________________________.
- When driving home if problems occur, I can _______________________________
- If I use public transit, I can ________________________________________
- I will go to different grocery stores and shopping malls to conduct
my business and shop at hours that are different than those when residing
with my battered partner.
- I can use a different bank and take care of my banking at hours different
from those I used when residing with my battered partner.
- I can also __________________________________________.
Step 6: Safety and drug or alcohol use. Most people
in this culture use alcohol. Many use mood-altering drugs. Much of this
use is legal and some is not. The legal outcomes of using illegal drugs
can be very hard on a battered victim, may hurt his/her relationship with
their children and put him/her at a disadvantage in other legal actions
with the battering partner. Therefore, victims should carefully consider
the potential cost of the use of illegal drugs. But beyond this, the use
of any alcohol or other drug can reduce a victim's awareness and ability
to act quickly to protect themselves from the battering partner. Furthermore,
the use of alcohol or other drugs by the batterer may give him/her an
excuse to use violence. Therefore, in the context of drug or alcohol use,
a victim needs to make specific safety plans.
If drug or alcohol use has occurred in my relationship with the battering
partner, I can enhance my safety by some or all of the following:
- If I am going to use, I can do so in a safe place and with people
who understand the risk of violence and are committed to my safety.
- I can also ___________________________________________.
- If my partner is using, I can _____________________________.
- I might also _________________________________________.
- To safeguard my children, I might ________________________
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:
- If I feel down and ready to return to a potentially abusive situation,
I can _____________________________________________.
- When I have to communicate with my partner in person or by telephone,
I can ____________________________________.
- I can try to use "I can . . . " statements with myself and
to be assertive with others.
- I can tell myself - "_____________________________________ ______________________________"
whenever I feel others are trying to control or abuse me.
- I can read ____________________________to help me feel stronger.
- I can call ___________________, ___________________ and _________________as
other resources to be of support of me.
- Other things I can do to help me feel stronger are __________________________,
- I can attend workshops and support groups at the domestic violence
program or _________________________, or _____ _______________to gain
support and strengthen my relationship with other people.
Step 8: Items to take when leaving. When victims leave
partners, it is important to take certain items with them. Beyond this,
victims sometimes give an extra copy of papers and an extra set of clothing
to a friend just in case they have to leave quickly.
Money : Even if I have never worked, I can legally take
1/2 of the funds in the checking and savings accounts as Tennessee is
a community property state. If I don't take any money from the accounts,
he/she can legally take all money and/or close the account and I may not
get my share until the court rules on it if ever.
These items might 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 have:
- Identification for myself
- Children's birth certificate
- My birth certificate
- Social security cards
- School and vaccination records
- Checkbook, ATM (Automatic Tellers Machine) card
- Credit cards
- Keys - house/car/office
- Driver's license and registration
- Welfare identification, work permits, Green card
- Passport(s), Divorce papers
- Medical records - for all family members
- Lease/rental agreement, house deed, mortgage payment book
- Bank books, Insurance papers
- Small saleable objects
- Address book
- Pictures, jewelry
- Children's favorite toys and/or blankets
- Items of special sentimental value
Telephone numbers I need to know:
Police department - home - 911
Metro Domestic Violence Division - (615) 880-3000
Nashville District Attorney General's Office - (615) 862-5500
Police department - school _____________________________
Police department - work ______________________________
Battered victims program - (615) 297-8833 (Nashville) ____________
County registry of protection orders ______________________
Supervisor's home number_____________________________
I will keep this document in a safe place and out of the reach
of my potential attacker.
IF YOU NEED HELP IN FILLING OUT THIS PLAN YOU MAY ASK METRO POLICE
DOMESTIC VIOLENCE DIVISION DETECTIVES, COUNSELORS, YMCA SHELTER WORKER,
THE DISTRICT ATTORNEY'S VICTIM WITNESS OFFICE PERSONNEL OR A CLOSE AND
SUPPORT IS JUST A PHONE CALL AWAY (615) 880-3000
Call Monday - Friday from 8 a.m. to 5 p.m. and ask to speak with a