Workplace Reporting Tool

Strategies to Empower People is committed to the safety and well-being of all its employees. We investigate all reports of Workplace Violence or threats to people or property.

To *anonymously report a Workplace Violence incident you have knowledge about (whether you were directly involved or just witnessed or heard about it), please answer the questions in the space provided below. *You may also fill in the OPTIONAL contact information but are not required to do so.

Your responses will remain confidential, and will be used to investigate any reports of Workplace Violence to the best of our ability given the information you provide.

PLEASE NOTE: If the incident you are reporting represents immediate danger to persons or property, you may call 911 to report. Please follow this with a report to the HR Director (Sandy Jones) at 916-420-2100 as quickly as possible.

Date of the Incident *

Time of the incident *

Location (please enter the location of the incident, be as specific as you can) *

Individuals involved (please name or describe the individuals involved in the incident) *

Summary description (Please describe the Workplace Violence incident you are reporting)

Optional: Please provide contact information (this is OPTIONAL, please provide contact information for yourself - your identity will remain confidential, but having a way to contact you will assist in our investigation if we have additional questions or need additional information. You can list a phone number, email address, or any other way of reaching you. THIS FIELD IS OPTIONAL AND NOT REQUIRED)

Name:

Phone Number

Email:

Other Contact:

Thank you for your report. It has been sent to Sandy Jones.

There was an error trying to send your report. Please attempt again, if there is continued issues, please try again later.