Safety Plan - Page 2 

  

To increase your safety when the relationship is over, consider the following (print, fill out, and store in a safe place):

  1.)  I can change the locks and install steel/ metal doors; a security system; smoke dectectors and an outside lighting system.

   2.)  I will inform _____________ and _______________ that my abuser no longer lives with me and ask them to call the police if he is observed near my residence or my children.

  3.)  I will tell people involved in the care of my children who has permission to pick them up.  The people who have permission are:

              ______________________________________________

              ______________________________________________

              ______________________________________________

              ______________________________________________

  4.)  I will tell_____________________ at work about my situation

        and ask _______________________ to screen my calls.

  5.)  I can avoid stores, banks and________________ that I used when living with my abuser.

  6.)  If my abuser is in custody and I want to be notified of his/ her release, I need to call the Custody Referee at 541-682-4201 as well as the shift supervisor of the Lane County Jail at 541-682-4263.

  7.)  I can obtain a restraining order from the Circuit Court and keep it on or near me at all times as well as a photocopy with  ____________________.

  8.)  If my abuser violates the restraining order, I will call the police

  9.)  If I have a restraining order and plan to move out of Lane County, I will get a certified copy of my restraining order for $10 by going to the Office of Court Records on the second floor of the Lane County Courthouse, 125 E. Eighth Avenue, in Eugene.  When I’ve moved, I will give this certified copy to the court in my new county of residence so I’ll still be protected under provisions of the Lane County restraining order.

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