Print or export as you go. Your responses are saved on this device only. Clearing your browser data or switching devices will erase your work. Use the Download PDF or Print button above to keep a permanent copy.

Safety Plan

A concrete plan for when substance use creates danger.

Week 9

Appendix I

Risk Assessment

Has there been violence or threats? Describe.

Is overdose a risk? Do you have Narcan?

Are children at risk? What's the plan for them?

My Safety Plan

Safe place I can go (address, who lives there)

Go-bag contents (keys, documents, medication, phone charger)

Emergency contacts (name & phone)

My signal to myself that it's time to leave