PETL/PEOT Workplace Violence Report

This form is for reporting violence toward a teacher. ETFO members who have experienced workplace violence (see definition below) should report the incident to their supervisor (e.g., Principal) and complete this report as soon as possible.

PLEASE NOTE: All ETFO members must also complete any incident reports required by Ministry regulation or Board policies and procedures (e.g., Safe Schools Incident Reporting Form, Accident Investigation Report, etc.).

The purpose of this PETL/PEOT Workplace Violence Report, which will be kept confidential within PETL/PEOT, is to gather information about the extent and nature of such incidents, in order to support our members who are experiencing workplace violence. The aggregate data collected from these reports will be used to help develop strategies to improve the safety and health of our members.

Definition of Workplace Violence:

  • The exercise of physical force by a person against a worker that causes or could cause physical injury to the worker;
  • An attempt to exercise physical force against a worker that could cause physical injury to the worker;
  • A statement or behaviour that it is reasonable for a worker to interpret as a threat to exercise physical force against the worker that could cause physical injury to the worker.

It does not matter that an aggressor may be incapable of making reasonable judgement prior to acting. All applicable reports
must be completed regardless. An aggressor’s lack of intent does not reduce the risk to the worker.


1. ETFO MEMBER’S INFORMATION




2. INCIDENT INFORMATION

eg: 09:09 a.m.


3. TYPE(S) OF VIOLENCE DIRECTED AT TEACHER


4. RESPONSE


5. OTHER INFORMATION