Paper forms · free

Two blank forms to print

An incident report and a training sign-in sheet. They are on paper on purpose: this site never stores reports about incidents or the names of people.

Put your organisation’s name on them

Workplace violence incident report

Organisation: ______________________________

If anyone is in danger, call 911 first. Give this form to the person named in your prevention plan. Report all incidents immediately in writing.

Date and time		Location
Reported by		Phone
Type	☐ Threat ☐ Verbal abuse ☐ Harassment or intimidation ☐ Physical assault ☐ Robbery ☐ Other: ______________
Who was involved	☐ Employee ☐ Customer or client ☐ Visitor ☐ Contractor ☐ Someone known personally to an employee ☐ Unknown
What happened
Injuries	☐ None ☐ Yes (describe):
Police called	☐ No ☐ Yes, report no.:	Medical care offered	☐ No ☐ Yes
Witnesses
Follow-up (investigator)

After an incident, OSHA lists steps such as: “Report violent incidents to the local police promptly.” and “Investigate all violent incidents and threats, monitor trends in violent incidents by type or circumstance, and institute corrective actions.” (OSHA Fact Sheet DEP FS-3509, 10/2024)

Training sign-in sheet

Organisation: ______________________________

Date		Trainer
Topic

#	Name	Role	Signature
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18

Keep this sheet with your records. In the online plan, log only the date, topic and how many attended.