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A Plan To Be Violence Free
MY SAFETY PLAN

1. My name is......................................

2. This plan is to keep me and the following people safe.




3. The Physical signs that I am getting angry are:





3a. When I notice these signs or have them pointed out I will.....




4. The Emotional signs I am getting angry are:




4a.When I notice these signs or have them pointed out I will.....




5. The Behavioural signs that I am getting angry are:




5a.When I notice these signs or have them pointed out I will.....




6. When I am into the cycle of abuse these are the things I do most often.




6a. If I start to do these things or other abusive things or have it pointed out that I am doing them I will.....




7. I still hold onto the following beliefs that could make it hard for me to be non-violent in the future.




8. I learned the following things from hearing from victims of male violence that made me not want to be violent again.




9. My Time Out strategy that I have agreed with my partner, or worked out for me(only if you have no partner) is:




10. My support network includes the following people.




This plan should be completed before a crisis occurs and in conjunction with your support people

This page was last modified on January 4th 2001


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Mike Bannister

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Snail Mail:
11, Kookora St.,
Griffith, NSW 2680
Australia