Client Safety Plan Agreement

Purpose:

This Safety Plan is created collaboratively between the client and therapist/Nuran Clinic to support the client’s safety and well-being during times of emotional distress or suicidal thoughts. The purpose of this plan is to help identify warning signs, coping strategies, and resources the client can use to stay safe.

1. Warning Signs

These are thoughts, feelings, or behaviours that may indicate I am beginning to feel unsafe or at risk:

2. Internal Coping Strategies

Things I can do on my own to help calm myself or reduce distress:

3. Social Supports and Safe Places

People or places I can reach out to when I need support:

4. Professional and Emergency Contacts

If I feel unable to keep myself safe, I agree to contact one or more of the following:

• Therapist / Clinic: Nuran Clinic – 647-618-9080 / admin@nuranclinic.com

• Emergency Services: 911 (if in immediate danger)

• Talk Suicide Canada: 1-833-456-4566 (24/7)

5. Commitment to Safety

I understand that my safety and well-being are important.I agree that if I feel I may be in danger of harming myself, I will use the coping strategies and contacts listed above and seek help immediately.

This plan is not a legal contract, but a shared commitment between myself and my therapist/Nuran Clinic to prioritize safety and seek support during crisis.

6. Review Schedule:

This Safety Plan will be reviewed and updated as needed in future sessions.