[EMPLOYER NAME] prohibits and will not tolerate any form of workplace violence by an employee, supervisor, or third party, including[ vendors/patients/customers/subscribers/clients][ and] visitors[ both] at the workplace[ and at employer-sponsored events].

For purposes of this policy, workplace violence includes[ but is not limited to]:

This list is illustrative only and not exhaustive. No form of workplace violence will be tolerated.

[EMPLOYER NAME] prohibits all employees[ with the exception of [POSITION TITLE]] from possessing any weapons of any kind at the workplace[, while engaged in activities for [EMPLOYER NAME], and at [EMPLOYER NAME]-sponsored events]. [For purposes of this policy, the workplace is defined to include [EMPLOYER NAME]'s building[s], outdoor areas, and parking lots.]

Weapons include:

This list is illustrative only, and not exhaustive. [EMPLOYER NAME] prohibits employees from possessing any weapon at the workplace.

[EMPLOYER NAME] is committed to enforcing this policy against all forms of workplace violence. However, the effectiveness of our efforts depends largely on employees telling us about all incidents of workplace violence, including threats. Employees who witness any workplace violence should report it immediately[ using the Complaint Procedure described below]. In addition, if an employee feels that they or someone else may have been subjected to conduct that violates this policy, the employee should report it immediately[ using the Complaint Procedure described below]. If employees do not report workplace violence incidents, [EMPLOYER NAME] may not become aware of a possible violation of this policy and may not be able to take appropriate corrective action.

If you witness or are subjected to any conduct you believe violates this policy, you must speak to, write, or otherwise contact your direct supervisor or, if the conduct involves your direct supervisor, the [next level above your direct supervisor/[DEPARTMENT NAME]] as soon as possible.

Your complaint should be as detailed as possible, including the names of all individuals involved and any witnesses. [A Workplace Violence Complaint Form is available at [LOCATION DESCRIPTION] if you wish to use it.]

[EMPLOYER NAME] will directly and thoroughly investigate all complaints of workplace violence and will take prompt corrective action, including discipline or termination of employment. [EMPLOYER NAME] reserves the right to contact law enforcement[, if appropriate]. [To the extent permitted by law, [EMPLOYER NAME] reserves the right to seek a restraining order to prevent workplace violence against an employee.]

If you become aware of an imminent violent act or threat of an imminent violent act, immediately contact appropriate law enforcement and then contact [EMPLOYER' NAME]'s [security department/[DEPARTMENT NAME]].

[EMPLOYER NAME] provides an employee assistance program (EAP) for all employees[ and their eligible dependents]. The EAP is designed to help individuals manage personal problems that can impact their wellbeing and work performance. Treatment is confidential (unless an EAP counselor is required by law to disclose information, such as child abuse) and will not become a part of an employee's personnel records. For more information about the EAP, contact [the Human Resources Department/your benefits manager/[OTHER POSITION OR DEPARTMENT]].]

[EMPLOYER NAME] prohibits any form of discipline, reprisal, intimidation, or retaliation for reporting incidents of workplace violence of any kind, pursuing a workplace violence complaint, or cooperating in related investigations.

The [DEPARTMENT NAME] Department is responsible for the administration of this policy. If you have any questions regarding this policy or if you have questions about workplace violence that are not addressed in this policy, please contact the [DEPARTMENT NAME] Department.

The employment terms set out in this policy work in conjunction with, and do not replace, amend, or supplement any terms or conditions of employment stated in any collective bargaining agreement that a union has with [EMPLOYER NAME]. [Employees should consult the terms of their collective bargaining agreement./Wherever employment terms in this policy differ from the terms expressed in the applicable collective bargaining agreement with [EMPLOYER NAME], employees should refer to the specific terms of the collective bargaining agreement, which will control.]]

[I, _______________________ (employee name), acknowledge that on _____________________ (date), I received a copy of [EMPLOYER NAME]'s [NAME OF POLICY] and that I read it, understood it, and agree to comply with it. I understand that [EMPLOYER NAME] has the maximum discretion permitted by law to interpret, administer, change, modify, or delete this policy at any time[ with or without notice]. No statement or representation by a supervisor or manager or any other employee, whether oral or written, can supplement or modify this policy. Changes can only be made if approved in writing by the [POSITION] of [EMPLOYER NAME]. I also understand that any delay or failure by [EMPLOYER NAME] to enforce any work policy or rule will not constitute a waiver of [EMPLOYER NAME]'s right to do so in the future. I understand that neither this policy nor any other communication by a management representative or any other employee, whether oral or written, is intended in any way to create a contract of employment. I understand that, unless I have a written employment agreement signed by an authorized [EMPLOYER NAME] representative, I am employed at will and this policy does not modify my at-will employment status. If I have a written employment agreement signed by an authorized [EMPLOYER NAME] representative and this policy conflicts with the terms of my employment agreement, I understand that the terms of my employment agreement will control.

I, ________________________ (employee name), acknowledge that on ______________________ (date), I received and read a copy of [EMPLOYER NAME]'s [NAME OF POLICY][, dated [EDITION DATE]] and understand that it is my responsibility to be familiar with and abide by its terms. [I understand that the information in this Policy is intended to help [EMPLOYER NAME]'s employees to work together effectively on assigned job responsibilities.] This Policy is not promissory and does not set terms or conditions of employment or create an employment contract.]