Model Form for Reporting Incident/Threat of Workplace Violence

Date First Published on SafetySmart Compliance: February 3rd, 2012
Topics: Workplace Violence |

The Benefits

It’s important to capture all of the information necessary to do a proper investigation of reported attacks or threats of violence. Unfortunately, due to the volatility of the situation and the emotions involved, vital information often goes unreported and can’t be recaptured from memory later.

How to Use this Tool

Here are forms you can use to capture key information about incidents of violence from the worker who reports them. There are 3 different tools:

  • General Workplace Violence Report Form
  • Form Specifically for Reporting Violence or Abuse by a Supervisor
  • Abusive Supervisor Profile for resolving complaints
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