I. The health care team will further assess the type of trafficking and immediate needs of the patient and document the findings in the medical record:

1. • Address the following three issues before the patient leaves your site:
     1. Immediate risk: “If you return home, will you be in immediate physical danger?
     2. State of mind toward situation and possible change: What type of assistance would you like? Are there any changes you would like to make? What steps would help you towards those goals? What actions are you ready to take?”
     3. Suicide: “Have you had any suicidal thoughts?”
   • Assess safety:
     1. If the perpetrator is posing an immediate danger, call Security at [Insert Phone Number] OR Call the appropriate law enforcement agency depending on where you are located.
     2. Take seriously the patient’s level of fear and appraisal of immediate and future safety.
     3. Document the indicators of serious abuse or lethality:
        • An increase in frequency and severity of abuse
        • Violence outside the home
        • Denial of breaks, food, or water while at work
        • Denial of adequate personal protective equipment for hazardous work
        • An escalation of threats
        • The patient’s past attempts to leave, or
        • Plan to leave, or
        • Plan to leave the trafficker in the near future, or
        • Has sought outside intervention to end the abuse 
        • The trafficker has threatened friends or family members
        • The trafficker sexually assaults the victim (or an increasing number of assaults)
        • The use of weapons to inflict abuse
        • Access to weapons in the home
        • Threats of homicide or suicide
        • Violence towards the children
        • Physical abuse during pregnancy
        • Drug/alcohol use or abuse 
        • Victim indicates fear for their life
     4. Discuss indicators for lethality and concerns about safety with the patient. An example would be to say: “Because of the things that you have shared with me, I am concerned that you may be at risk for serious injury. I would like to talk to you about your options and help you plan for your safety.”
     5. Other questions to be considered when assessing for immediate danger include the following:
        • Is the patient’s trafficker here now or likely to return?
        • What would the patient like you to do if the trafficker attempts to have the patient leave the healthcare setting?
        • Does the patient want you to call security or police?
        • Does the patient want to leave with the trafficker?
        • Does the patient want information about local shelters?
        • Does the patient need someone to pick up their children from their location?
        • Does the patient have a personal protection order? If so, and the perpetrator comes to the hospital and the police are called, the police can arrest the perpetrator.
        • Does the patient need to be home by a certain time in order to avoid further abuse? If so, try to expedite the evaluation, but at a minimum make sure the patient receives referral numbers for domestic violence/intimate partner advocacy resources as well as human trafficking resources. 
        • Is the patient concerned about his or her immigration status? Does the patient need access to legal assistance?