Notes Develop response system if employee does not show for Permission for leader to call trusted person for unexpected work absences Name and phone number of trusted friend or relative Name________________________________ Tel. ___________________ Other Notes Notification of workers regarding the potential for violence What employees and affiliates should be notified? in the workplace How will they be notified? Confidentiality concerns / considerations of the victim and abuser Share information on a to know’ basis ‘needs Other Notes Guideline Individualized safety plan options Action Taken If necessary screen for the abuser by providing a photo or Assess areas/departments of the workplace for risk to description to Security employee or co-workers Obtain a recent picture Picture/description to security only Picture/description to security and specific department(s) Picture/description to the entire workplace Other Notes
Notes Develop response system if employee does not show for work Permission for leader to call trusted person for unexpected absences Name and phone number of trusted friend or relative Name________________________________ Tel. ___________________ Other Notes Notification of workers regarding the potential for violence in the workplace What employees and affiliates should be notified? How will they be notified? Confidentiality concerns / considerations of the victim and abuser Share information on a ‘needs to know’ basis Other Notes Guideline Individualized safety plan options Action Taken If necessary screen for the abuser by providing a photo or description to Security Assess areas/departments of the workplace for risk to employee or co-workers Obtain a recent picture Picture/description to security only Picture/description to security and specific department(s) Picture/description to the entire workplace Other Notes
Individualized_Safety_Plan_Template_1.docx