Template library · Assessments & screeners
Suicide Safety Plan template
Complete collaboratively with the client to plan for moments of crisis.
Collaborative safety plan for clients at elevated risk
- 17 fields across 3 sections
- Included with MyWellOps
- Edit it, or save your own version
What’s in it
Assessment Details
- Client NameText
- Date of BirthDate
- Client ID / MRNText
- Date of AssessmentDate
- Clinician / CoachText
- Location / ModalityText
Safety Plan Steps
- Personal warning signsText
- Coping strategies the client can use aloneText
- People and social settings that offer distractionText
- Family or friends to contact for helpText
- Professionals or agencies to contact (include crisis line)Text
- Making the environment safe (means restriction)Text
- Client's stated reasons for livingText
Signatures
- Clinician SignatureSignature
- Date signed (clinician)Date
- Client SignatureSignature
- Date signed (client)Date
When to use it
Use an assessment at the start of work to set a baseline, then repeat it at review points so you and the client can see what has changed.
How it works in MyWellOps
- Pick it from Documents.
- Send it to the client to complete, or fill it in together during a session.
- Each completed copy is kept on the client’s record, so earlier results are there to compare.
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