Safe Plan

Complete this Safe Plan to document how to keep you safe when you are having suicidal thoughts or feeling warning signs.

You can download a printable pdf or email your Safe Plan at the end of this form.

This is the suicide safe plan for:

Email:

My mobile phone:

Date of This Safety Plan:

Recognize Warning Signs - Do you have any thoughts, feelings, or behaviors that might show you or friends/family that you are starting to struggle? List them here:

Coping Skills/Immediate Plan - What can you do to keep yourself distracted and safe? Where will you be? Will there be any obstacles to any part of your plan?

Support - Is there anyone you can turn to for help or call if your coping skills aren’t enough? If you can, list a few people and their mobile phone numbers:

Important Numbers

Counselor or Therapist:

Support person:

Local Hospital Name/Location: