Stanford School of Medicine
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 in the 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 in 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).

 
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

In addition, we invite SUMC clinics and our community colleagues to download and use the following handouts for teens (also available on our Child Abuse website).

Handouts on this site:

Family Violence Prevention Fund
http://fvpfstore.stores.yahoo.net/healpractool.html
Very extensive patient materials - posters, information sheets, and safety cards in a variety of languages, most of which are free

Safe For All
http://www.safe4all.org/brochure
Download brochures about abuse for straight and gay men, and lesbians

LEAP (Look to End Abuse Permanently)
http://www.leapsf.org/patient.html
Downloadable safety sheets for pregnant and non-pregnant women in multiple languages

Medlineplus
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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