Human Trafficking Survivor Clinic Security Risk Assessment Checklist

Use this checklist to guide a private, individualized safety assessment—not to assume that a survivor or accompanying person poses a threat. Adapt it to your clinic’s emergency plan, applicable law, and privacy policies. The HEAL Trafficking Protocol Toolkit recommends assessing the facility and planning for emergencies while recognizing that a patient’s presence usually does not create danger.

How to assess immediate danger and the survivor’s response preferences

When it is safe to do so, speak with the patient alone in a private room. Use calm, nonjudgmental language and ask what they want staff to know before taking action. Do not require them to disclose a trafficking experience to receive care.

• Ask whether they feel safe right now and whether anyone is waiting for them, monitoring them, or trying to contact them.
• Ask what they fear might happen if they do not leave with someone or return to a particular place, and whether they believe anyone else may be at risk.
• Find out whether the person they fear is in the building or nearby, and whether the patient wants help contacting security, an advocate, or emergency services.
• Ask how staff can communicate safely, including whether calls, texts, voicemail, patient-portal messages, or printed materials could put them at risk.
• Clarify the patient’s preferences about who may accompany them, who may receive updates, and what staff should do if someone asks about their presence.
• If a child or dependent may be at risk, follow the clinic’s safeguarding procedures and promptly consult the appropriate designated lead about applicable reporting duties.

Let the patient’s knowledge of their circumstances guide the plan. A safety plan should reflect their current concerns and preferences; it should not presume that leaving immediately is safe or desired. The National Human Trafficking Hotline’s safety-planning guidance emphasizes tailoring plans to the individual and honoring their requests.

How to protect privacy and explain confidentiality limits

Before asking sensitive questions, explain who may see or receive information, how it may be recorded, and the circumstances in which disclosure may be required or permitted. Do not promise absolute confidentiality. Be specific, use plain language, and pause to check what the patient understands.

• Conduct the conversation out of hearing of visitors, companions, and other patients. Offer a qualified interpreter when needed rather than relying on a companion to interpret.
• Ask which contact methods and locations are safe. HIPAA-covered providers must allow patients to request reasonable alternative means or locations for confidential communications; see the HHS Summary of the HIPAA Privacy Rule.
• Limit staff access to sensitive information to people who need it for their role. Avoid announcing the patient’s name, location, or reason for the visit in public areas.
• Explain that HIPAA disclosures to law enforcement are allowed only under specific conditions. HIPAA generally permits, but does not itself require, a disclosure in those circumstances; other laws may impose separate duties. Refer staff to HHS guidance on disclosures to law enforcement and the clinic’s privacy officer.
• If the patient is a minor, promptly consult the clinic’s safeguarding lead about applicable state reporting requirements. HHS explains that HIPAA permits certain reports of child abuse or neglect to officials authorized by law, but the relevant reporting duties depend on applicable law.

What clinic access controls and security-sensitive areas to review

Review how a visitor could locate or reach the patient, access staff-only spaces, or learn who is receiving care. Use routine, consistent visitor procedures rather than singling out a patient in a way that could disclose their situation.

• Check reception, check-in screens, waiting areas, public directories, appointment lists, and staff conversations for ways a patient’s presence or location could be revealed.
• Review access control for clinical rooms, staff work areas, medication storage, records, and exits. Confirm that keys, badges, codes, and visitor escorts are managed under clinic policy.
• Identify private rooms where staff can speak with a patient, and a discreet way to request assistance if a visitor becomes threatening or attempts to enter a restricted area.
• Set a consistent response for inquiries about whether someone is at the clinic. Staff should not confirm or disclose a patient’s presence or location unless the disclosure is authorized under applicable law and clinic policy.
• Protect the medical record from unnecessary access. Use any discreet safety alert only if approved by the privacy and security leads, with clear instructions about who may see it and what action to take.

Ask clinic security, facilities, and privacy leadership to review the site’s risks and response plan together. The HEAL Trafficking Protocol Toolkit recommends assessing the physical facility and planning with clinic security for potentially threatening situations.

How to prepare staff for threats or attempted removal

Create a written response for threats, stalking, unauthorized access, or attempted patient removal. Make sure reception, clinical staff, managers, and security know whom to contact and what information they may share. Practice the plan without using a patient’s identity or details.

• Assign roles in advance: who stays with the patient, who contacts the designated lead or security, who calls emergency services if needed, and who manages nearby patients and staff.
• Agree on a discreet way for staff to call for help and identify a safe room or other location consistent with the facility’s emergency procedures.
• Train staff not to confirm the patient’s presence, room, appointment, or departure plans to an unauthorized person. Use a calm, consistent response at reception.
• If someone attempts to remove a patient, follow the clinic’s emergency protocol and the patient’s stated preferences when feasible. Do not escalate by confronting or physically restraining someone unless staff are trained and authorized to act under applicable policy and law.
• Document observable conduct and actions taken in a factual, neutral manner. Avoid assumptions or unnecessary detail that could expose the patient to added risk.
• After an incident, review what happened, preserve relevant information under clinic policy, and revise the response plan as needed.

Security involvement should be based on a specific safety concern and the clinic’s protocol, not on an assumption that trafficking survivors are dangerous. The HEAL Trafficking Protocol Toolkit notes that a patient’s presence usually does not pose danger, while recommending preparation for situations that do require security support.

How to provide trauma-informed care and respect patient choices

Trauma-informed care prioritizes safety, trust, dignity, and the patient’s control over decisions. Explain each step before proceeding, ask permission, and make clear that the patient may pause, decline, or stop an examination or discussion. The Office for Victims of Crime’s victim-centered standards emphasize informed choices, self-determination, and safeguarding against practices that may retraumatize survivors.

• Offer choices when possible, such as who is present, where the conversation takes place, and whether to discuss a topic now or later.
• Avoid pressuring the patient to tell their story repeatedly, make a report, leave a relationship or situation, or accept a referral.
• Use respectful language, explain clinical options and their purpose, and obtain consent for each examination or procedure.
• Offer a qualified interpreter, accessible communication, and culturally responsive care when needed.
• Do not promise protection, housing, confidentiality, or a particular outcome that the clinic cannot guarantee.
• Offer a warm referral to an advocate or service provider if the patient wants one, while letting them decide whether to accept it.

How to plan emergency exits and safe transportation

Discuss departure options privately and ask what the patient considers safe. A plan that works for one person may increase risk for another, so avoid assuming that a particular exit, vehicle, companion, or destination is appropriate.

• Identify more than one possible route from the care area, including a discreet option if available. Keep routes consistent with the facility’s emergency procedures and do not block required exits.
• Ask whether the patient wants to leave alone, with a trusted person, with an advocate, or by arranged transport. Do not disclose their destination to others without permission unless disclosure is required or permitted by applicable law.
• Confirm that the proposed ride, driver, pickup point, and contact method are safe from the patient’s perspective.
• Ask whether the patient has safe access to a phone, essential medication, identification, or other items they want to take. Do not delay urgent care or pressure them to collect belongings.
• If a threat is present, follow the emergency response plan and consult the patient about the safest available option when circumstances allow.
• Agree on what staff should do if the person the patient fears appears, follows them, or tries to contact them after departure.

The National Human Trafficking Hotline’s safety-planning guidance recommends developing practical options for responding when safety is threatened and tailoring the plan to the individual’s circumstances.

What medical, mental health, housing, and referral needs to assess

Ask what the patient needs today and what they would like help arranging next. Assess urgent concerns first, explain available options, and obtain consent before making referrals or sharing information. A patient may need more than one service, and the clinic does not have to provide every service itself.

• Medical care: Ask about urgent symptoms, injuries, ongoing health conditions, medications, dental needs, and any examinations or testing the patient would like to discuss. Explain options before proceeding and obtain consent.
• Mental health and substance-use support: Ask whether the patient wants emotional support, counseling, or help with substance-use concerns. Assess immediate clinical safety concerns using the clinic’s standard professional protocols.
• Basic needs and housing: Ask whether the patient wants help with a safe place to stay, food, clothing, transportation, or access to essential medication and personal documents.
• Advocacy and legal support: Offer connections to a victim advocate or, if requested, immigration or other legal assistance. Do not make law enforcement contact a condition of care or referral.
• Communication and access: Ask about interpretation, disability accommodations, safe follow-up, and whether a phone or online account may be monitored.
• Referrals: With the patient’s permission, offer a warm handoff to a local provider. The Office for Victims of Crime’s guidance for anti-trafficking professionals describes potential needs including advocacy, housing, food, medical and dental care, mental health treatment, interpretation, and legal assistance.

Checklist summary: Assess immediate danger with the survivor, explain privacy limits, secure the clinic’s spaces and information, prepare staff for threats, respect the patient’s choices, plan a safe departure, and offer care and referrals based on the patient’s priorities.

FAQs

What should clinic staff do if a suspected trafficker is present?

Do not assume the person’s presence alone means there is an immediate threat. If it is safe, speak with the patient privately, ask what they want staff to do, and assess the specific concern. Follow the clinic’s security protocol if someone threatens, follows, or attempts to remove the patient. Do not confirm the patient’s presence or location to an unauthorized person. The HEAL Trafficking Protocol Toolkit recommends planning for threatening situations while noting that a patient’s presence usually does not create danger.

How can a clinic protect a survivor’s privacy during an assessment?

Offer a private room, ask whether the patient wants anyone present, and use a qualified interpreter when needed. Limit access to information, avoid public conversations about the visit, and ask which contact methods are safe. Explain confidentiality limits before asking sensitive questions. HIPAA-covered providers must allow patients to request reasonable alternative means or locations for communications, as described in the HHS Summary of the HIPAA Privacy Rule.

When should clinic staff contact security or law enforcement?

Contact clinic security according to the site’s protocol when there is a specific concern such as a threat, attempted unauthorized access, or attempted patient removal. Call emergency services when there is an immediate danger requiring urgent response. A suspected trafficking situation alone does not mean law enforcement must be contacted. HIPAA permits certain disclosures to law enforcement under defined circumstances, but does not itself require every permitted disclosure; applicable reporting laws and clinic policy also matter. See HHS guidance on law-enforcement disclosures.

What should be included in a safe departure plan?

Ask the patient which exit, transportation, companion, destination, and communication method feel safe. Confirm whether the pickup and driver are trusted, what staff should do if a threatening person appears, and whether the patient wants help connecting with an advocate or other service. Tailor the plan to the patient’s circumstances rather than assuming that leaving immediately is the safest choice.