Telehealth services are critical to ensuring that people who experience intimate partner violence (IPV) have access to needed mental health and substance use care. At the same time, accessing services from home when an abusive partner is present can pose safety, security, and privacy risks to survivors of IPV and other household members. IPV survivors report consistent challenges to accessing care due to interference by abusive partners (e.g., monitoring or listening in on sessions, trying to prevent or disrupt participation, threatening the treatment provider). Behaviors such as tracking access to technology, monitoring phone and internet usage, attempting to access electronic health records, impersonation, and location surveillance are common. Given the widespread adoption of telehealth services and efforts to support expanded access, it is crucial that telehealth services are both widely accessible and safe. This document is designed to highlight the ways in-home telehealth services can create safety and security risks for people experiencing IPV and to provide guidance on strategies that can be incorporated into telehealth practice to increase safety for IPV survivors and their families.