Workplace Violence Incident Report Form
The attached form must be used to document any reportable workplace violence incident.
For any Level I incident, an employee must report the incident to the Department Head within 48 hours of the occurrence.
For all Level II and Level Ill incidents, the incident must be reported immediately.
The Department Head is responsible for completing and forwarding this form to the Human Resources Director and/or Safety Engineer within the same timeframes.
- Workplace Violence Incident Report Form (345.09 KB)