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Friends For Lives Safety Plan
Please include as much Information as possible.
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1
Name
First Name
Last Name
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2
Email
example@example.com
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3
Phone Number
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4
What is most important to me and worth living for?
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5
What can keep me safe? (e.g. Meeting friends, walking, listening to music, helping others, etc.)
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6
What will I do to keep me safe when feel unsafe?
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7
Names and phone numbers of people I know that I can contact:
By completing this section you agree that we may call these contacts in case of an emergency this may require you to obtain their permission first. If so please let us know and we can complete this section with you at a later date.
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8
Names and numbers of professionals I can contact:
Samaritans Call 116 123 Emergency Services Call 999
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9
Any other information I want to add...
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10
Support Notes (Admin Only)
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11
Please verify that you are human
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