undefined
HomeAll templatesviolence formsworkplace violence form

Workplace violence form

This form is to be used by employers to document workplace violence incidents.

2 minutes to complete

Eligibility

The workplace violence form is open to any employee who has been a victim of workplace violence.

undefined

Questions for Workplace violence form

Questions

1.

Have you ever experienced workplace violence, or been the victim of workplace violence?

The answer should be a single choice:
  1. Yes
  2. No
2.

If you answered yes to the previous question, please describe the incident/incidents in as much detail as possible.

The answer should be a text input.
3.

Do you feel that your workplace is generally safe, or are there safety concerns that you have?

The answer should be a text input.
4.

Have you ever witnessed workplace violence, even if you were not the victim?

The answer should be a single choice:
  1. Yes
  2. No
5.

If you answered yes to the previous question, please describe the incident/incidents in as much detail as possible.

The answer should be a text input.
6.

In your opinion, what are the root causes of workplace violence?

The answer should be a text input.
7.

What do you think could be done to reduce or prevent workplace violence?

The answer should be a text input.
8.

Do you have any other comments or suggestions regarding workplace violence?

The answer should be a text input.

Forms Similar to Workplace violence form

  • Violence in the workplace form
  • Workplace aggression form
  • Workplace bullying form
  • Harassment in the workplace form
  • Threats in the workplace form

Here are some FAQs and additional information
on Workplace violence form

What is workplace violence?

Workplace violence is any act or threat of physical violence, harassment, intimidation, or other threatening behaviour that occurs at the work site. This can include but is not limited to, threats or attempts to physically harm another person, property damage, and theft.

What are some signs that someone may be a victim of workplace violence?

Some signs that someone may be a victim of workplace violence include, but are not limited to: -Unexplained absences from work -Decreased productivity -Increased absenteeism -The decreased quality of work -Increased use of sick days -Increase in accidents or errors -Difficulty concentrating -Withdrawal from co-workers or social activities -Changes in eating or sleeping habits -Unexplained weight loss or gain

What are some signs that someone may be a perpetrator of workplace violence?

Some signs that someone may be a perpetrator of workplace violence include, but are not limited to: -Making violent or threatening statements -Displaying aggressive or erratic behaviour -Making repeated personal threats -Violating workplace policies -Possessing weapons or making threats to use weapons -Stalking co-workers or other employees -Engaging in harassment or bullying

What are some steps that employers can take to prevent workplace violence?

Some steps that employers can take to prevent workplace violence include, but are not limited to: -Developing a zero-tolerance policy for workplace violence -Encouraging employees to report any incidents of workplace violence -Conducting regular training on workplace violence prevention -Creating a safe and secure work environment -Monitoring employee behaviour for warning signs of violence -Providing counselling and assistance to employees

Want to use this template?

Testimonials

G2 BadgesG2 BadgesG2 BadgesG2 BadgesG2 Badges

What's next? Try out templates like
Workplace violence form

1000+ Templates, 50+ Categories

Explore more
undefined
Workplace violence form
This form is to be used by employers to document workplace violence incidents.
undefined
Violence against women survey
The Violence against Women Survey is a study that collects information from women about their experiences with violence, whether it was physical, sexual, or psychological. The survey also collects information on women's use of self-defense, to protect themselves from victimization.
undefined
Sexual violence survey
Sexual violence survey aims to collect data on the prevalence of sexual violence in a population. The survey is typically conducted by interviewing a sample of individuals from the population. The survey may ask about the respondent's personal experiences with sexual violence, as well as their knowledge, attitudes, and beliefs about sexual violence.
undefined
Family violence survey template
This Family violence survey is a questionnaire that can be used by organizations to conduct a survey on family violence. This template can be used to collect data on the prevalence of family violence, the types of family violence that occur, and the impact of family violence on individuals and families.
undefined
Gun violence survey
The Gun Violence Survey can be used to collect data about gun violence in a community. It can be used to collect data about the prevalence of gun violence, the types of gun violence that occur, and the factors that contribute to gun violence. The survey can also be used to collect data about the impact of gun violence on the community, and the strategies that are being used to address gun violence.
undefined
Domestic violence affidavit form
A domestic violence affidavit is a sworn statement that is typically used in domestic violence cases. The affidavit may be used to provide evidence of domestic violence or to request a restraining order.
undefined
Gender based violence survey
The Gender Based Violence Survey is a national survey that collects data on the prevalence of different forms of violence against women and men. The survey covers a range of topics, including physical violence, sexual violence, emotional abuse, and financial abuse. The data collected from the survey is used to inform policy and program development, and to raise awareness of the issue of gender-based violence.
undefined
Domestic violence report form
The Domestic Violence Report Form is a document that is used to report instances of domestic violence. This form can be used by individuals who have experienced domestic violence, or by witnesses to domestic violence. The form asks for basic information about the incident, including the date, time, and location of the incident, as well as the names and contact information of the parties involved. The form also asks for a description of the incident, and any injuries that were sustained.
undefined
Domestic Violence Survey
Domestic violence survey template is a ready to use document which can be used by anyone who wants to conduct a survey on the issue of domestic violence. This template is very easy to use and can be edited as per the requirement of the user. This template can be used by any individual or organization which wants to collect data on the issue of domestic violence.
undefined
Domestic violence victim intake form
Domestic violence victim intake forms are used by police and domestic violence agencies to gather information about an incident of domestic violence. The form is used to document the victim's account of what happened, as well as any injuries sustained. The form is also used to collect information about the perpetrator, including their name, address, and any previous history of domestic violence.

Want to create secure online forms and surveys?

Join BlockSurvey.

SHARE