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Checklist for Assistance - Intimate Partner Violence

This checklist only serves as a guide for addressing important issues, including support resources, related to the assault with the student. Discuss only as many steps as you feel the student can handle at that time. Regardless of what information you were able to discuss, please make sure that the student receives a survivor information packet, available through the RVSP Program office (817-272-9250).

1. _____ ENSURE SAFETY. In an Emergency, call UT Arlington Police at 817-272-3003 or 911 if the assault occurred off campus.


3. _____ CONTACT THE RVSP program at 817-272-9250 (with permission only).


With the student's consent, refer them to Arlington Memorial Hospital (817-548-6100), USMD Hospital (817) 472-3400, Health Services (817-272-2771), to a local clinic, or to their personal physician for treatment of acute injuries.

  • Inform them of the importance of medical care to screen/treat for injuries regardless of when the assault occurred.
  • Inform the student that visible injuries will be documented and photographed. Advise them that it is also recommend to re-photograph visible injuries 2-3 days after the assault.
  • If the student is seeking immediate medical care, the RVSP Coordinator on campus or a Safe Haven Victim Advocate can accompany them. If the student needs transportation to the hospital, the RVSP Coordinator can be contacted directly at (817-272-9250) as well as UT Arlington Police (for immediate medical care) at 817-272-3003.

5. _____ ADVOCACY and COUNSELING. Offer the student referrals to:

  • UT Arlington Counseling Services at 817-272-3671 and Mental Health Services at 817-272-2771 (information, confidential consultation and/or counseling).
  • RVSP Program at 817-272-9250 (advocacy/referrals).
  • Safe Haven of Tarrant County 24-hour hotline at 877-701-7233 (information, counseling, referrals).

6. _____ REPORTING. Offer referral for reporting resources:

  • Anonymous reporting on RVSP website.
  • Official Reporting via UT Arlington Police at 817-272-3003 or Arlington Police at 817-459-5600.
  • Office of Student Conduct for reporting within the University at 817-272-2354.

7. _____ ACCOMMODATIONS. Offer referral as needed to:

  • Apartment and Residence Life (“alternative housing” accommodations) at 817-272-2926.


  • Inform the student that an Anonymous Relationship Violence Incident Report Form will be filed with the RVSP Coordinator. Advise the student that her/his name and other identifying information will not be released without her/his permission (unless the student or university community is in imminent danger in which case 911 should be called whether the student consents or not).
Emergency: Call 911UT Arlington Police