Family Violence Initiative

Call 911 in an emergency

People I can call for help are:

Name: Local Police
Phone Number: _______________
Other Number: _______________

Name: _______________
Phone Number: _______________
Other Number: _______________

Name: _______________
Phone Number: _______________
Other Number: _______________

Places for me to go are:
______________________
______________________
______________________

I can call Kids Help Phone line at 1-800-668-6868 for advice.

Someone I trust and can talk to about my worries is:
____________________
Their phone number is:
_____________________________
Their address is:
____________________________________
We have agreed on the code word _______________ in case I need help.
They know my address and phone number.
They can call help for me.

Things to take with me if I can:

• Medicines I need
• Cash if I have any
• Clothing for a few days
• Identification (like my health card or birth certificate)

In an emergency I will not worry about these, I will just get to safety.

Remember to keep this plan in a safe place where you can get it if you need it.

You may want to keep addresses, phone numbers or other information you’d need in an emergency with you.

It’s a good idea to get help making a safety plan from a trusted adult or information helpline.

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