Templates
Workplace violence prevention plan template

Workplace violence prevention plan template

This workplace violence prevention checklist template is intended as a prevention tool to help employers put systems and procedures in place to prevent workplace violence.

Use this template with Lumiform

The Lumiform application helps frontline teams uphold internal standards effortlessly.
  • Customize this template or build your own
  • Fill out templates via mobile app
  • Assign and track corrective actions
  • Get reports and analyse your data
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or Download template as PDF
Workplace violence prevention plan template

This workplace violence prevention checklist template is intended as a prevention tool to help employers put systems and procedures in place to prevent workplace violence.

Use this template with Lumiform

The Lumiform application helps frontline teams uphold internal standards effortlessly.
  • Customize this template or build your own
  • Fill out templates via mobile app
  • Assign and track corrective actions
  • Get reports and analyse your data
Prices start from ░░░ per month
Book a demo
Learn more
or Download template as PDF

Our workplace violence prevention plan template helps you create a comprehensive safety system to protect your team from workplace violence incidents. This checklist takes you through establishing critical elements like leadership support, reporting systems, and emergency response protocols.

The US Centers for Disease Control and Prevention found that there was an annual average of 1.3 million nonfatal workplace violent incidents. With the checklist, you can spot potential gaps in your prevention strategy. For instance, if there’s threatening behavior between employees, using this checklist might help you discover a lack of a clear reporting system or threat assessment.

Related categories

Preview of the template
Workplace Violence Prevention Checklist
Leadership Support and Worker Participation
Do you have a written Workplace Violence Prevention Policy against threats and intimidating behaviors in the workplace?
Do you have a written policy to identify the consequences and disciplinary actions that result when/ if threats or aggressive behaviors occur?
Have you conducted a Front-End-Analysis / Worksite Planning Assessment of the needed policies, systems and structures to "institutionalize" your Workplace Violence Prevention System?
Our organization has established a crisis management/chain of command team and their roles and responsibilities are clearly outlined in a procedure (who responds first, who are first complaints reported to, who is next in line to receive the complaint if that individual is not available or does not act upon the complaint
Do you have a system to report threats of violence and intimidation so employees know whom to call with concerns?
Have you established and trained a Behavioral Threat Assessment Safety Team to investigate and manage threats, "high-risk terminations", violent and intimidating incidents?
Have you trained your employees to identify "early warning signs" of potential violence or intimidation?
Have you conducted a hazard/risk audit of "near misses" and/or violent incidents at your facilities?
Have you developed and practiced Active Shooter / Evacuation / Lock Down plans?
Have you developed a Crisis Recovery Plan for the aftermath of workplace emergencies and violent events?
Have you identified external resources and threat assessment experts to help you evaluate threatening individuals/situations?
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Frequently asked questions

What should I do if our organization fails multiple items on this workplace violence prevention checklist?

Start by prioritizing the most critical gaps—typically policy development, reporting systems, and threat assessment teams. Create an action plan with specific timelines and responsible parties for each item. Consider bringing in an external safety consultant to help address complex areas like threat assessment protocols or active shooter response planning.

What are the most commonly overlooked items on this workplace violence prevention checklist?

Organizations frequently neglect crisis recovery planning, assuming their work ends after an incident. Many also fail to conduct “near miss” audits that could reveal valuable prevention insights. Third, threat assessment teams are often formed but not properly trained or given clear authority to act on concerns.

How can I adapt this workplace violence prevention checklist for a small business with limited resources?

Focus first on establishing clear policies, simple reporting procedures, and basic emergency response plans. For specialized roles like threat assessment, consider sharing resources with neighboring businesses or contracting part-time expertise. Free training resources are available through OSHA and local law enforcement to help small businesses build prevention capabilities cost-effectively.

What’s a good way to train employees on recognizing “early warning signs” mentioned in this checklist?

Develop scenario-based training that illustrates behavioral indicators like increasing aggression, fixation on grievances, or sudden changes in behavior. Keep sessions practical rather than theoretical. Provide clear guidance on what to report and how. Follow up with regular refreshers and incorporate real examples (anonymized) from your industry to maintain relevance.

This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.