Purpose of this assessment:
This guide is provided by the Blue Ridge Partnership for Workplace Violence Prevention (BRPWVP) as an initial resource for evaluating concerning information/incidents and suggesting appropriate courses-of-action. This guide is separate from, yet complimentary to, more thorough analyses used by the BRPWVP, internal risk-management mechanisms, and/or other similar resources.
This form is intended to serve as a recommended guide for determining the most appropriate course-of-action an organization may take upon receiving information concerning a possible threat of violence or harm towards that organization or its employees.
This form is NOT a directive by any person, group, or agency, public or private, and does not assert any legal authority over any party.
The courses-of-action included in this form are not exhaustive, nor are the criteria used to tabulate those recommended actions. Regardless of the recommended course-of-action indicated through completing this form, if there exists an imminent concern for the safety of any party or an active incident requiring immediate assistance, contact 911 immediately.
Using this assessment:
Upon receipt of information which could possibly concern the safety of an organization or one of its employees from harm or violence, identify any of the pre-selected criteria on the following page which may apply. If any of those criteria apply to the situation being evaluated refer to the corresponding suggested course-of-action for next-step guidance. If multiple criteria apply in more than one category, refer to the category of more serious concern.
If none of the pre-selected criteria apply to the situation being evaluated and/or additional consultation is desired, please e-mail your inquiries to the BRPWVP.
Please complete all applicable fields based on all available information. All reports must include the name of the report submitter and valid contact information (phone number or e-mail address) for the BRPWVP to follow-up with. Anonymous submissions will not be accepted. Works best in Google Chrome.
Email, spoken threat, letter, etc.
Name of person that received the threat.
Person completing this online form.
If ANY of the criteria apply, IMMEDIATELY CALL 9-1-1 and request police response.
If ANY of the criteria below apply, contact the BRPWVP representative as soon as possible.
If ONLY these criteria apply incident should be assessed further through the organization's internal mechanisms (internal threat assessment team, management / administration, or human resources).
Please select an agency below to receive your complaint. This agency will investigate your complaint for further action or recommendations.
This field is not part of the form submission.
* indicates a required field