Workplace violence intake that captures retaliation and reporting
Our intake asks whether the incident happened at work, whether it was reported to HR or security, and whether your prospective client faced retaliation after speaking up — while collecting incident reports and HR correspondence before the case reaches your desk.
The exact intake your workplace violence prevention leads complete
This is the real 7-question guided intake for Workplace Violence Prevention — the same flow your customers finish before you ever pick up the phone.
What a qualified workplace violence prevention lead should tell you
Legal matters arising when a prospective client experienced workplace violence, threats, harassment, or intimidation on the job, then reported it and faced an employer's failure to protect them or retaliation for speaking up.
- Workplace Violence, Threats, Harassment,
- Employee (Not Business Owner)
- Report Situation Supervisor, Hr,
- After Reported It (Or
- Suffer Harm Because Situation
- Employer Punish Or Treat
- Any This Happen Within
The questions your team needs answered
Every workplace violence prevention intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Did the workplace violence, threats, harassment, or intimidation happen at your job (or because of your job) in the United States? | Confirms the incident happened on U.S. employment turf — a 'no' signals the matter may fall outside employment law coverage entirely. |
| Were you an employee (not the business owner) at the time this happened? | Employee status separates protected employment claims from owner or manager disputes, which need a different legal theory. |
| Did you report the situation to a supervisor, HR, security, or management? | Internal reporting is the foundation for proving the employer knew about the risk before anything else can be assessed. |
| After you reported it (or asked for help), did your employer fail to take reasonable steps to protect you or address the risk? | Employer inaction after a report is one of the highest-weighted signals — it's often the core of the legal claim itself. |
| Did you suffer harm because of the situation (for example, physical injury, fear for your safety, medical treatment, missed work, or needing a safety plan)? | Documented harm, such as injury, missed work, or medical treatment, turns a safety complaint into a claim with real damages. |
| Did your employer punish you or treat you worse after you reported the violence or asked for safety (for example, firing, cutting hours, demotion, threats, or discipline)? | Retaliation after reporting is heavily weighted because it can support a separate, often stronger, retaliation claim. |
| Did any of this happen within the last 2 years? | The two-year window flags potential statute-of-limitations exposure that needs review before you invest consultation time. |
How Cliont scores workplace violence prevention leads
Every answer is weighted automatically — no manual review required.
Value signals
- Workplace Violence, Threats, Harassment,: yes
- Employee (Not Business Owner): yes
- Report Situation Supervisor, Hr,: yes
- After Reported It (Or: yes
- Suffer Harm Because Situation: yes
- Employer Punish Or Treat: yes
See the lead your team receives
Workplace Violence Prevention Lead
From first click to qualified lead
Follow people and businesses seeking counsel through one smooth, guided flow.
They land & meet you
Your video greeting plays instantly — a real face instead of a blank form.
They explain the matter
Smart questions adapt to their matter and capture the full scope.
They share the documents
The facts, dates, and any paperwork come attached, so you can assess the matter before the consultation.
You get a ready lead
Scored and qualified — waiting for you to win it.
Built for workplace violence prevention workflows
| Cliont capability | Workplace Violence Prevention application |
|---|---|
| Weighted qualification scoring | Employer failure to protect and post-report retaliation carry the highest weights in this catalog, so leads describing employer inaction or punishment after a report rise straight to High Priority. |
| Branching yes/no intake logic | If the prospective client never reported the incident internally, the intake still completes but can't confirm employer inaction or retaliation, which shows up as a lower score for your own review. |
| Video or voice intake widget | Lets the prospective client describe the threat, incident, or intimidation in their own words before you commit consultation time. |
| Document upload capture | Collects incident reports, HR complaint correspondence, and medical documentation upfront so you can weigh harm and reporting history before the call. |
| CRM lead routing | Sends only leads that clear your workplace violence thresholds — U.S. employment, employee status, timely incident, and reported harm — directly into your CRM as case-ready matters. |
Common workplace violence prevention lead scenarios
Reported, then retaliated against
The prospective client told HR or security about the threat, then was fired, demoted, or disciplined afterward. The intake surfaces the reporting and retaliation answers together, pushing this straight into your high-priority queue.
Employer ignored a safety complaint
A report was made, the employer took no protective steps, and the client was later harmed — physically, medically, or by missing work. This mix of employer inaction and documented harm is what the score is built to catch.
Owner or manager, not an employee
The person filing the form wasn't an employee at the time of the incident. That answer lowers fit because business-owner disputes need a different legal theory than an employee protection claim.
Incident outside the two-year window
The violence or threats happened more than two years ago. The intake still captures the facts but flags the timing for your review before you decide whether a consultation makes sense.
Connect Cliont to your workflow
Send leads
HubSpot, HighLevel, Salesforce, JobNimbus
Book matters
Google Calendar, Outlook Calendar, Calendly
Notify your team
Email, SMS, Slack
Automate follow-up
Zapier, Webhooks, API
Simple, transparent pricing
Choose the plan that works for your business.
Professional
Unlimited intake forms and leads for your growing business.
- Unlimited intake forms
- Custom video greetings
- AI-powered voice bot
- English + Spanish support
- Automatic lead scoring
- Digital estimates & e-signatures
- Photo, video & file upload
- Advanced analytics dashboard
Pay Per Lead
Only pay when you receive a qualified lead.
- Unlimited intake forms
- Custom video greetings
- AI-powered voice bot
- English + Spanish support
- Automatic lead scoring
- Digital estimates & e-signatures
- Photo, video & file upload
- Charged only for submitted leads
More employment and labor law intake templates
Workplace Violence Prevention lead-intake FAQs
What if the prospective client never reported the incident to HR or security?
The intake still moves forward, but without an internal report you can't confirm the employer knew about the risk or failed to act on it, so the lead scores lower until you review the specifics yourself.
How does the intake treat business owners who fill out the form?
Employee status is one of the higher-weighted answers, so a prospective client who wasn't an employee at the time lowers the score — flagging the matter for owner or manager-specific review rather than a standard employee safety claim.
Does the two-year timeframe automatically disqualify older incidents?
No. The intake asks whether the incident happened within the last two years and factors the answer into scoring, but it's meant to flag potential statute-of-limitations exposure for your review, not to reject the lead outright.
How does the intake separate the original harm from later retaliation?
Harm from the violence itself and any punishment after reporting it are asked as two separate weighted questions, so you see both signals independently before deciding on a consultation.
Does this overlap with Hostile Work Environment or Retaliation and Whistleblower intakes?
Workplace Violence Prevention is scoped to threats, violence, or intimidation and the employer's safety response; Hostile Work Environment and Retaliation and Whistleblower cover broader conduct. Route the lead to whichever matches the facts, or run both if the answers overlap.
What documents does the intake collect from the prospective client?
It requests incident or police reports, HR complaint correspondence, medical documentation of any harm, and disciplinary or termination notices if retaliation is alleged — before the lead ever reaches your inbox.
Turn workplace violence prevention visitors into qualified cases
Give every workplace violence prevention visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book a consultation.