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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
or download 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
or download pdf

About the Workplace violence prevention plan template

Employers can take a variety of steps to minimize workplace harassment and violence, or to give employees a sense of safety by knowing who to contact when conflicts arise. A workplace violence prevention plan template is designed to help you examine the current state and achieve the target state by designing an action plan. It allows you to standardize your protocols and get your team aligned before a situation escalates.

Build safer protocols and improve compliance

This workplace violence prevention plan template consists of actionable sections that help you move from strategizing to implementation. You’ll find space to document policies, reporting systems, team roles, and recovery plans, all organized in a way that’s easy to complete, share, and revisit.

You can use the template to assign responsibilities, track who needs to respond first, and outline how to escalate reports when needed. This helps avoid confusion during high-pressure moments and ensures quick, confident action.

This template benefits you by giving your team a shared reference point. It replaces inconsistent processes with one unified plan, saving you time and minimizing legal and operational risks. This enables you to build a culture of accountability and readiness.

How to use the workplace violence prevention plan template

This template is especially useful for safety managers or HR leads responsible for rolling out standardized plans. Here’s how to make the most of it:

  1. Customize the template to fit your organization’s structure. Adjust the sections to reflect your internal chain of command, specific reporting protocols, and any industry-specific risks. Add or remove fields to match the terminology your team already uses. The template is fully editable in the Lumiform app.
  2. Assign the checklist to the responsible lead. This is usually your safety officer, HR manager, or operations lead. They’ll walk through the full checklist, input relevant info, and save it as your working draft.
  3. Add clear guidance for frontline staff. Use the template to document how threats should be reported, who to contact, and what steps are required for documentation. Keep the language simple and specific so it’s easy for anyone to follow in real-time.
  4. Track completion and document gaps. Once filled out, the template becomes a dynamic document. You can revisit it regularly to identify weak spots in your current plan, like unclear roles or missing contact info.
  5. Use analytics to improve your prevention efforts. Inside Lumiform, you can monitor completion rates, spot trends in reporting, and export your filled templates as needed to share with leadership or external partners,

Create a prevention plan with confidence

Start building a prevention strategy that actually works on the ground. With Lumiform’s template, you guide your team through critical points, from early warning signs to response protocols, without second-guessing what to include or how to present it. You can adapt it to your organization’s exact needs, revisit it as your policies evolve, and make it a core part of your long-term safety planning.

Related categories

  • Health and safety management templates
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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?
Confirmation
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Date
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Related resources

Access a complete set of resources aimed at maximizing safety, quality, and operational excellence, including detailed guides, related templates, and real-world use cases.

Topic guides

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Frequently asked questions

What should a workplace violence prevention plan actually include?

A strong plan clearly outline how employees report incidents, who handles each step, and what the follow-up process looks like. Include details like how to spot early warning signs, what to do during an incident, and how to debrief after one.

Who should be involved in developing the plan?

Get input from more than just HR. Security staff, shift supervisors, floor managers, and even union reps (if relevant) can offer real insight into on-the-ground issues. The more your plan reflects day-to-day operations, the more likely it is people will actually use it. It also makes buy-in a lot easier when employees feel represented.

How do you keep the plan active?

Treat it like part of your workflow rather than a standalone document. Schedule periodic reviews, such as every quarter, to revisit the plan and update it based on new risks, staffing changes, or lessons learned from real situations. Use team meetings or safety briefings to keep it fresh in everyone’s mind.


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.
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