Free report template · Word

Workplace Violence Report

A workplace violence report records threats, physical assault, intimidation with weapons or violent behaviour at work, by employees, customers or outsiders. It prioritises immediate safety, records whether police or medical help was called, and sets out the facts and follow-up actions, including protection for those who reported it.

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[Company Logo][Company Name]

WORKPLACE VIOLENCE REPORT

Report No.:: [Reference Number]
Site:: [Work Location]
Date:: [Date]
Classification:: Confidential

1. Immediate Safety (complete first)

Parties separated and area secured
Medical help provided or called
Security informed
Police informed (if required)
Senior manager and HR informed

2. Reporter

Name
Employee ID
Designation / Department
Contact Number

3. Nature of Incident

Verbal threat of harm
Threatening message (phone, chat, email)
Pushing or physical contact
Physical assault
Use or display of a weapon
Damage to property
Other

4. Details

Date and time
Exact location
Description of what happened (facts only)
Persons involved: Employees (name, ID)
Persons involved: Outsiders (customer, visitor, contractor)
Witnesses (name, ID)

5. Injuries and Outside Help

Persons injured and nature of injury (general)
Hospital / clinic
Police station informed and complaint / FIR number (if any)
CCTV preserved (camera location)

6. Follow-up

Action	Owner	Due Date
Inquiry into conduct of employees involved	[HR Name]	[DD/MM/YYYY]
Security review of site	[Security Head]	[DD/MM/YYYY]
Counselling support for affected staff	[HR Name]	[DD/MM/YYYY]

All persons who reported or witnessed this incident are protected from retaliation. Information in this report will be shared only with those who need it for safety, inquiry or legal purposes.

Reporter
[Name]
Date: [Date]

Security / Site Head
[Name]
Date: [Date]

HR
[HR Name]
Date: [Date]

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What this template includes

Immediate safety check at the top of the form
Type and severity of violence
Persons involved, including outsiders
Police, ambulance or security involvement
Injuries in general terms
Witness list and CCTV preservation
HR, security and management follow-up plan

When to use it

A physical fight breaks out on the shop floor, office or site
An employee is threatened with harm, in person or by message
A customer or visitor assaults a front-line employee at a branch, hospital or store
Property is deliberately damaged during an altercation

How to customise this template

1Add your emergency, security and local police numbers
2Include your site's assembly or safe-room location
3Name who decides on interim suspension under standing orders
4Add a field for FIR or complaint number if police are involved
5Link the report to your incident register

HR tips

Safety first: separate the parties and get medical help before filling forms
Preserve CCTV immediately
Offer counselling to affected employees and witnesses
Any disciplinary action must follow a fair inquiry

This template is a starting point. Review it against applicable labour laws, your standing orders, safety rules and with a legal adviser; criminal matters may also need to be reported to the police.

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Frequently asked questions

What counts as workplace violence?+

Physical assault, threats of harm, intimidation, and violent damage to property at work or in a work context.

Should the police be called?+

If there is injury, a weapon or a continuing threat, call emergency services. The company should support affected employees in making a police complaint if they wish.

Can an employee be suspended after a violent incident?+

Interim suspension may be allowed under the standing orders pending inquiry, but a fair inquiry must still be held before any final action.

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Report · Word
Workplace Incident Report
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[Company Logo][Company Name]
GRIEVANCE INVESTIGATION REPORT
Case No.:
[Reference Number]
Report Date:
[Date]
Prepared by:
[Investigator Name], [Designation]
Submitted to:
[Decision Maker Name]
Classification:
Strictly Confidential
1. Executive Summary
This report sets out the investigation into the grievance raised by [Employee Name], [Designation], on [Date]. Of the [Number] issues investigated, [Number] were substantiated, [Number] were not substantiated and [Number] were inconclusive.
2. Background and Terms of Reference
[Brief neutral description of the grievance.] The investigator was appointed on [Date] by [Name] to examine: (a) [Issue 1]; (b) [Issue 2]; (c) [Issue 3].
3. Methodology
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Grievance Investigation Report
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[Company Logo][Company Name]
WORKPLACE COMPLAINT FORM
Site / Unit:
[Work Location]
Form No.:
[Reference Number]
Date:
[Date]
Anyone working at this site may use this form. You may give your name or leave it blank. For complaints of sexual harassment please contact the Internal Committee: [IC Presiding Officer Name], [Phone].
About You (optional)
Name
Employee ID / Gate Pass No.
Category: Employee / Contract Worker / Trainee / Apprentice
Contractor Company (if applicable)
Department / Line
Shift
Contact Number
Type of Complaint
- Safety hazard or unsafe practice
- Washroom, drinking water or hygiene
- Canteen or food quality
- Transport or shuttle
- Wages, overtime or deductions
- Behaviour of a person
- Equipment, PPE or tools
- Other
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[Company Logo][Company Name]
WORKPLACE CONFLICT FORM
Company:
[Company Name]
Form No.:
[Reference Number]
Date:
[Date]
1. Submitted By
Name [Employee Name]
Employee ID [Employee ID]
Designation / Department
Submitting as: Party to the conflict / Manager / Other
2. Parties Involved
Name Designation Department Working Relationship
[Employee Name] [Designation] [Department] [Peer / Reports to / Cross-team]
[Employee Name] [Designation] [Department] [Relationship]
3. Nature of Conflict
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Workplace Conflict Form
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[Company Logo][Company Name]
INCIDENT REPORT FORM
Report No.:
[Reference Number]
Site:
[Work Location]
Date of Report:
[Date]
Reported By
Name
Employee ID
Designation / Department
Contact Number
Type of Incident
- Injury or illness
- Near miss
- Property damage
- Loss or theft
- Security breach
- Verbal or physical altercation
- Other
Incident Details
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Incident Report Form
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Employee Misconduct Report
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[Company Logo][Company Name]
COMPLAINT REGARDING WORKPLACE BEHAVIOUR
Date:
[Date]
To,
[HR Name]
Human Resources
[Company Name]
[Company Address]
Subject: Complaint regarding the behaviour of [Name], [Designation]
Dear [HR Name],
I am [Employee Name], [Designation] in the [Department] team (Employee ID [Employee ID]). I am writing to formally bring to your notice the behaviour of [Name], [Designation], towards me, which I believe is not in line with the company's code of conduct.
The incidents are as follows:
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Workplace Behaviour Complaint
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[Company Logo][Company Name]
ETHICS INVESTIGATION REPORT
Case No.:
[Reference Number]
Report Date:
[Date]
Prepared by:
[Investigator Name]
Submitted to:
Ethics Committee, [Company Name]
Classification:
Strictly Confidential
1. Allegations
No. Allegation Code of Conduct Clause
1 [Allegation] [Clause]
2 [Allegation] [Clause]
3 [Allegation] [Clause]
2. Scope and Approach
The investigation covered the period [Date] to [Date] and included review of [purchase orders, vendor master, expense claims, emails], interviews with [Number] persons and analysis of [data]. The reporter's identity has been withheld from this report.
3. Evidence Summary
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Time	Event	Source
[Time]	[Event]	[Witness / CCTV / Log]
[Time]	[Event]	[Source]
[Time]	[Event]	[Source]