Patient safety template 2025

1. Click ‘Get Form’ to open the patient safety template in the editor.
2. Begin with Step 1, where you will identify warning signs of a potential crisis. List at least three thoughts, images, moods, situations, or behaviors that may indicate a developing crisis.
3. Move to Step 2 and document internal coping strategies. Write down three activities that can help distract you from your problems without needing to contact someone else.
4. In Step 3, list people and social settings that provide distraction. Include names and phone numbers for at least two individuals and two places.
5. Proceed to Step 4 to identify individuals you can ask for help. Record their names and phone numbers for easy access during a crisis.
6. In Step 5, note professionals or agencies you can contact during a crisis. Include clinician names, their contact information, and local urgent care services.
7. Finally, in Step 6, make your environment safe by listing items or actions that can help ensure your safety.

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