Ontario Secondary School Teachers' Federation
District 29 Hastings–Prince Edward

OSSTF D29 Violent Incident Online Form

IT IS RECOMMENDED THAT YOU CLEAR YOUR BROWSER HISTORY BEFORE FILLING OUT AN ONLINE FORM
(This will allow your browser to recognize that there is a new or refreshed version of the form).

VIOLENT INCIDENT encompasses any aggressive act that causes physical or emotional harm to a member and includes violence or any threatening statement that gives the member reasonable cause to believe there is a risk of physical or emotional harm. Intent is not a factor in determining risk to members. It does not matter that an assailant may be incapable of making a reasoned judgment prior to acting. OSSTF members who have been victims of violence at work should complete this report as soon as possible.

The purpose of the Violent Incident Report, which will be kept confidential, is to gather information about the extent and nature of such incidents, and to assist OSSTF in developing strategies to improve the safety and health of OSSTF members. The aggregate data will also be used to develop reports, to be submitted to your employer or other bodies, as appropriate.

PLEASE NOTE: OSSTF members must also continue to complete any incident reports under Board policy, WSIB, etc.

An asterisk (*) indicates required information.



Contact Information
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Assailant Information
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Incident and Injury information
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Types of Violence:











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Response
Medical Attention?

First Aid obtained?

WSIB forms completed?

Police called?

Reported to supervisor?

Other Information
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