Check out this Personal Safety Plan.
an excerpt from that page linked above:
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Step 2. Safety when getting ready to leave.

I can use the following strategies:

a. I will leave money and an extra set of keys with___________________________________________.

b. I will keep important documents and keys at_______________________________________________________.

c. I will open a savings account by this date___________________________________ to increase my independence.

d. Other things I can do to increase my independence are:_______________________________________________________________________
__________________________________________________________________________

e. The domestic violence hotline is _____________________.

f. The shelter's hotline is _________________________.

g. I will keep change for phone calls with me at ALL times. I know that if I use a telephone credit card, that the following month the telephone bill will tell the batterer who I called after I left. I will keep this information confidential by using a prepaid phone card, using a friend's telephone card, calling collect, or using change.

h. I will check with_________________________ and ______________________ to know who will let me stay with them or who will lend me money.

i. I can leave extra clothes with___________________________.

j. I will review my safety plan every ___________________(time frame) in order to plan the safest route. I will review the plan with ______________________________ (a friend, counselor or advocate.)

k. I will rehearse the escape plan and practice it with my children.

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