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System · 165 documentsPart of Civil Roadworks Integrated Industry Suite

Workplace Violence Report Form

Form · FORM-31126

  • Version 2

Workplace violence takes many forms, such as a threat or actual physical violence, harassment, intimidation, or other threatening disruptive behaviour. The Workplace Violence Report Form can be used to document a violent incident should it occur in the workplace.

The form helps capture all necessary details, providing a comprehensive record that can be used for further action if required.

It collects the details of the person reporting and the person assaulted, the type of incident and its description, witness details and roles, and follow-up actions such as a police report or investigation.

Written by SafetyDocs safety experts, who have been writing safety documents since 2004.

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Preview of the Workplace Violence Report Form

Workplace Violence Report Form

FormVersion 2

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What it covers

22 fields

  1. Administrative use only. Date Submitted
  2. Name of person reporting
  3. Phone
  4. Mobile ph
  5. Email
  6. Manager Name
  7. Manager ph
  8. Manager Email
  9. Name of the person assaulted
  10. Person assaulted address
  11. The person assaulted ph
  12. Person Assaulted Manager Name

and 10 more

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