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This form is designed to document any reportable incidents of workplace violence within Cattaraugus County. It collects detailed information regarding the victim, perpetrator, witnesses, and specific details of the incident to ensure proper reporting and follow-up.
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How to fill out workplace violence report form

01
Gather all necessary information regarding the incident, including date, time, location, and individuals involved.
02
Describe the details of the incident, including what occurred, any injuries sustained, and witnesses present.
03
Include your contact information and any relevant information about your position at the workplace.
04
Indicate any immediate actions taken in response to the incident, such as contacting security or law enforcement.
05
Review the form for completeness and accuracy before submitting.
06
Submit the form to the designated HR representative or workplace safety officer as per your organization's protocol.

Who needs workplace violence report form?

01
All employees who witness or experience workplace violence need to fill out the report form to document the incident.
02
Managers and supervisors must complete the form if they are informed about a workplace violence incident.
03
Human Resources personnel and safety officers may need the report to take necessary actions and implement safety measures.
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The workplace violence report form is a document used to formally report incidents of violence that occur within the workplace. It helps in documenting the details of the incident for investigation and prevention purposes.
Employees who experience or witness incidents of workplace violence are typically required to file the workplace violence report form. Employers may also be mandated to file reports for significant incidents.
To fill out the workplace violence report form, provide accurate details such as the date and time of the incident, description of what occurred, names of individuals involved, witnesses, and any injuries sustained. Ensure the form is signed and dated.
The purpose of the workplace violence report form is to document incidents of violence for analysis, to aid in preventive measures, and to ensure a safe working environment by tracking trends and incidents.
Information that must be reported includes the date and time of the incident, location, individuals involved, a detailed description of the incident, injuries sustained, and any actions taken in response.
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