Domestic Abuse

Patient Materials

SUMC Patient Abuse Referral and Resource Sheets

These sheets, which can be folded up small and hidden, have been developed by the SUMC Family Abuse Prevention Council. They include various county and national hotlines, as well as danger assessment and safety plan on the back.

Available in seven languages, they can be found in plastic holders in various areas at Stanford Medical Center (picture), or from Social Work. Contact us for information about obtaining holders.

We are pleased to make these sheets available for free download for use by the community. For download, print on both sides and then cut into thirds.

You may also choose to buy these sheets in printed tear off pads of 50 from Standard Register (510)768-0721 (use Form numbers).

The new phone number for Deaf Hope is (510) 267-8800

English downloadPDF Form 100-1216
Spanish downloadPDF Form 100-1216S
Chinese downloadPDF Form 100-1216C
Russian downloadPDF Form 100-1216R
Vietnamese downloadPDF Form 100-1216V
Tagalog downloadPDF Form 100-1216T
Farsi downloadPDF Form 100-1216F

Parent Handout
Created by the Santa Clara County Domestic Violence Council, these non-judgmental handouts help parents realize how yelling, abuse and violence in the home affect their children. Included are recommended books, hotlines and websites.

Teen Health Relationship Sheets
These sheets help teens understand what a healthy relationship is and isn't, suggestions on how to break up with an abusive partner, and highlight the National Teen Dating Abuse Helpline - 24/7 all languages.

Handouts on this site:

Family Violence Prevention Fund
Very extensive patient materials - posters, information sheets, and safety cards in a variety of languages, most of which are free

Stop Abuse For Everyone
Download brochures about abuse for straight and gay men, and lesbians

LEAP (Look to End Abuse Permanently)
Downloadable safety sheets for pregnant and non-pregnant women in multiple languages

Extensive list of articles for patients on a variety of aspects of abuse

Key approaches:
  • Create an office/clinic atmosphere where a patient can feel more comfortable talking about the subject
  • Have materials available for the patient to read/take without her having to reveal abuse.
Accomplish these goals by:
  • Having a policy where the patient is always seen alone for at least part of the visit.
  • Placing posters/pamphlets that include hotline numbers in the waiting room, exam rooms, bathrooms.
  • Having these materials include effects on children, as this is often a powerful motivator for women to leave an abusive relationship
  • Considering your patient population re: language, culture, and gender orientation of your materials.

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