Workplace Violence Threat Assessment

Workplace Violence Threat Assessment — Form Fields

This hr template includes 13 fields. Confidential threat assessment form for reporting workplace violence concerns. Free to customize and use on ZenBuild.

• Reporter Name (or Anonymous) (text, optional)
• Contact Email (for follow-up) (email, optional)
• Date of Incident or Concern (text, required)
• Location (text, required)
• Nature of Concern (dropdown selection, required) — options: Verbal Threat, Physical Intimidation, Written Threat, Weapon Mention, Stalking Behavior, Property Damage, Domestic Violence Spillover, Social Media Threat
• Threat Level Assessment (dropdown selection, required) — options: Low (concerning but not immediate), Medium (pattern or escalation), High (specific threat made), Imminent (immediate danger)
• Person of Concern (name if known) (text, optional)
• Relationship to Workplace (dropdown selection, required) — options: Current Employee, Former Employee, Customer/Client, Visitor, Domestic Partner of Employee, Unknown, Contractor
• Witnesses Present (multiple choice, required) — options: Yes, No
• Detailed Description of Concern (long text, required)
• Any Prior Incidents or Pattern (long text, optional)
• Law Enforcement Contacted (multiple choice, required) — options: Yes, No, Unsure if Warranted
• Need Immediate Security Response (multiple choice, required) — options: Yes, No