Safety Planning Tool

Appendix 8.1 – Intake and Risk Assessment Checklist

Please note

This appendix is a work in progress, and any data entered into these fields will not be retained.

Survivor Information

Presenting Concern

Type of victimization:
Is victimization ongoing?

Risk Assessment Indicators

Offender Behaviour and Intent

For example: place of education, address etc.

For example: a friend, a family friend, a teacher etc.

For example: content distribution, stalking etc. perpetrated by multiple offenders

Content Distribution and Exposure
Content in circulation:

For example: live links to content on CSA related sites/platforms

Within the last 3 years

It has been 3+ years since the last known/strongly suspected incident of content distribution

Personal information disclosed/discussed:

Examples: Victim's first name, approximate location such as town or city.

Example: Full name of the victim, full current home address of the victim. This risk factor may also be relevant for cases where multiple ‘partial information’ data points have been publicly shared and the aggregation of them could realistically result in identification.

For example: large follower base, victim is an influencer

For example: full name in bio

This includes direct attribution (e.g. victim named) and indirect attribution (e.g. victim not named but media coverage attributed to the victim by individuals familiar with the case such as offenders)

For example: collages made of the victim, victim is described as being of fundamental importance to the CSA spaces

Psychological/Functional Impact

This may include panic attacks but not always

Protective Factors

Reporting and Intervention

Reporting and intervention:

Risk Profile

Assigned risk profile: