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What Every Target of Workplace Bullying Needs to Know

Workplace Bullying Incident Reporting Form

by Bully Magnet

Hi. Since I've come to terms with my "born to be bullied" condition, I've researched methods to try and get some control over it. So I've lovingly prepared an incident form for documenting offensive behaviors. As we all know, legally, if it wasn't documented, it didn't happen. So, I started by listing the behaviors that we should be held accountable to and the reporting form follows.


Standards of professional/ethical conduct include treating fellow employees, supervisors, staff, subordinates, and clients/patients/customers with respect, empathy, compassion, and sensitivity. We must work towards a supportive work/learning environment and behave in an ethical, responsible, and dependable manner. We must maintain truthful and honorable work/academic standards while upholding professional manners with appearance and conduct. When given constructively, discreetly, sincerely, and respectfully, we should accept criticisms in order to take responsibility for ourselves and correct ourselves or change protocols as deemed appropriate.

If you witness a violation of the above outlined behavioral standards that was directed towards you or someone else (coworker, client, supervisor, subordinate, etc.) WRITE IT UP and remember people, THERE IS NO EXCUSE EVER FOR BULLYING OR MOBBING BEHAVIORS.

As my contribution, I've prepared an “incident reporting form” for inappropriate behaviors in the work or academic environment. Please use this form or tweak it as you see fit. I wrote it by reviewing multiple established company policies then re-wrote all my favorite elements...


Name of Violator(s): _________________________________

Date of Incident: ___________________
Time of Incident: ___________________

Date Form Initiated: ___________________

Person(s) Initiating Form (include contact info if appropriate): _________________________________

Description of incident:

Witness(es) To Incident: _________________________________

Negative Consequences of Incident: (example, “customer/client/patient service was compromised due to poor or offensive communication “, “customer left due to feeling offended”, “Service was delayed due to lack of efficiency”, “work efficiency compromised related to time loss in having to write up more paperwork for insubordinate behavior of employee”, etc. _________________________________

Actions Taken To Resolve Issue: (Some examples: “incident report reviewed with offending party and corrective counseling/education provided” or “Report forwarded to management for review”, or “Policies/protocol procedure guidelines contributing to incident will be reviewed and revised”, etc.

Comments for Workplace Bullying Incident Reporting Form

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by: Anonymous

Will really be useful to me.

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