Page 9 - Horizons Manual
P. 9
Safety Contract
I, ________________________, contract for my safety. This means I will not act on my plan to commit suicide. I will use the skills listed below to assist with my safety, call my team members/people in my support system/crisis numbers listed below as needed, or admit myself into the hospital if needed.
DBT skills I will use to maintain my safety: 1)
2)
3)
4)
5)
Team members/other people in my support system/crisis numbers I can call for help are:
1)
2)
3) COPE (Hennepin County)
4) National Suicide Prevention Lifeline 5) Emergency
Phone number: Phone number: 612-596-1223
1-800-273-8255 911
Client signature and date: __________________________________ Therapist signature and date: _______________________________
9
