Assault Incident Reporting Form

Sample

Put a procedure in place for reporting incidents internally and to the police. A form would include:

Date

Time

Location of incident

Description of incident

Who was directly involved

Name, title, address, phone number

Relationship between people involved (spouse, ex co-worker, supervisor, etc.)

Who witnessed the event

Witnesses’ experience of the events (what they saw; what was said by whom, etc.)