Collaborative Safety-Planning Worksheet

How to use it

1. Complete this only with a qualified professional who can assess current safety and explain available choices.
2. Choose what to record about warning signs, internal options, safer settings, supportive people, and professional resources.
3. Add access details, barriers, backups, and any locally required safety steps.
4. Pause or stop if completing the page increases risk or distress; seek immediate local help when safety cannot wait.

Reflection prompts

• Which step is most reachable, and what could make it easier to use?
• What backup is needed if a person, place, or resource is unavailable?

Facilitator guidance

Use only within a current individualized risk assessment and the practice's approved safety-planning protocol. Customize professional resources, escalation routes, confidentiality limits, safeguarding duties, documentation, and any means-safety content to local law, licensing rules, setting, age, access, and policy. Confirm feasibility rather than merely filling every box.

Adaptations & accessibility

• Create a discreet portable or digital version only when storage is safe.
• Use icons, dictation, translated copy, or supported communication.
• Develop separate daytime, nighttime, access-barrier, and unavailable-support backups.

Review considerations

Enhanced licensed trauma/safety specialist, legal, safeguarding, and local-policy review is required before use. Local crisis and emergency information must be added by the implementing practice. This worksheet alone is not a sufficient protection, risk assessment, emergency response, or substitute for immediate local help.