Suicidal Safety Plan Template - Attempted Suicide Help

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Suicidal Safety Plan
1. Actions I know will calm myself, tools I choose to use:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
2. Mantras:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
3. My valuable reasons to stay alive:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
4. Two people I will call when I am feeling suicidal or thinking suicidal thoughts:
Name:
Name:
Phone:
Phone:
Suicidal Safety Plan
1. Actions I know will calm myself, tools I choose to use:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
2. Mantras:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
3. My valuable reasons to stay alive:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
4. Two people I will call when I am feeling suicidal or thinking suicidal thoughts:
Name:
Name:
Phone:
Phone:
5. I will call a care provider (psychologist, psychiatrist, therapist) when I need them:
Name:
Name:
Phone:
Phone:
6. My local suicide crisis line phone number and national number:
Phone:
1-800-273-TALK
7. Places I can go where I am safe:
_____________________________________________________________________________________
_
8. I commit to go to the Emergency Room at the nearest hospital when I need to. If I can’t
make it there safely I will call 911 for transportation.
*Attempted Suicide Help, and the creator of ASH, is not responsible for any thoughts or actions you, or your loved one may have, or not have
after, completing this safety plan. This template is an example of many you can find on the internet and is meant as a tool. It was created out of
concern and love for all humans who face suicidal ideation.

Download Suicidal Safety Plan Template - Attempted Suicide Help

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