Template Safety Details

Are you looking for a safety plan template form? If so, you've come to the right place. In this blog post, we will discuss what a safety plan is and how it can help keep you safe. We will also provide a link to download a free safety plan template form. Finally, we will give you some tips on how to create your own safety plan. Read on for more information. download here: https://www.yoursafetyplanner.com/safety-plan-template-form/ Safety planning is an important step that anyone can take to protect themselves from harm. A safety plan is essentially a personalized action plan that outlines the steps a person can take to ensure their safety in a variety of situations.

If you want to first understand how much time you will need to fill out the safety plan template and the number of pages it has, here is some detailed data that might be useful.

QuestionAnswer
Form NameSafety Plan Template
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namessuicide safety plan template, patient safety plan, safety plan pdf, safety plan printable

Form Preview Example

Patient Safety Plan Template

Step 1: Warning signs (thoughts, images, mood, situation, behavior) that a crisis may be developing:

1._____________________________________________________________________________________________

2._____________________________________________________________________________________________

3._____________________________________________________________________________________________

Step 2: Internal coping strategies – Things I can do to take my mind off my problems without contacting another person (relaxation technique, physical activity):

1._____________________________________________________________________________________________

2._____________________________________________________________________________________________

3._____________________________________________________________________________________________

Step 3: People and social settings that provide distraction:

1.Name____________________________________________________ Phone______________________________

2.Name____________________________________________________ Phone______________________________

3.Place__________________________________________ 4. Place______________________________________

Step 4: People whom I can ask for help:

1.Name____________________________________________________ Phone______________________________

2.Name____________________________________________________ Phone______________________________

3.Name____________________________________________________ Phone______________________________

Step 5: Professionals or agencies I can contact during a crisis:

1.Clinician Name____________________________________________ Phone______________________________

Clinician Pager or Emergency Contact # _________________________________________________________

2.Clinician Name____________________________________________ Phone______________________________

Clinician Pager or Emergency Contact # _________________________________________________________

3.Local Urgent Care Services______________________________________________________________________

Urgent Care Services Address___________________________________________________________________

Urgent Care Services Phone_____________________________________________________________________

4.Suicide Prevention Lifeline Phone: 1-800-273-TALK (8255)

Step 6: Making the environment safe:

1._____________________________________________________________________________________________

2._____________________________________________________________________________________________

Safety Plan Template ©2008 Barbara Stanley and Gregory K. Brown, is reprinted with the express permission of the authors. No portion of the Safety Plan Template may be reproduced

without their express, written permission. You can contact the authors at bhs2@columbia.edu or gregbrow@mail.med.upenn.edu.

The one thing that is most important to me and worth living for is:

________________________________________________________________