Thursday, November 20, 2008

This sample form is provided as a general guideline for your review only and with the understanding that neither the publisher nor the writers are providing legal advice or other professional service. The law changes regularly and varies from state to state, and you should not rely on or use this or any form without consultation with a competent attorney in your state.


It is the policy of the company that hostility, threats, intimidation, assaults and/or violence will not be tolerated. In order to insure a safe, productive work environment at all company facilities it is necessary that this policy be strictly enforced. If you are aware of any type of hostility, threat, intimidation, assault or violence by an employee of the company, please contact a management person immediately. Because the company desires to stop violent behavior before it occurs, it is important to know some of the early warning signals. The following are some of the signs which may indicate a potential for violence:

1. Verbal threats of harm, e.g., predicting that bad things are going to happen to a co-employee or supervisor.

2. Intimidating others or instilling fear in co-employees or supervisors.

3. Threatening actions such as menacing gestures or flashing of concealed weapons.

4. Obsessive behavior in the form of holding a grudge against a coworker or supervisor or, in some cases, a fascination with an unrequited romantic interest.

The above signs are only a few possible indications of potential violence in the workplace. Please notify an appropriate management person if you are concerned that workplace violence may occur. The company needs each employee's assistance in reporting violations of this policy and in maintaining a safe and productive work environment.

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