Name of employee reporting the incident (unless a ''privacy concern case").*Note: If the case is a ''privacy concern case," remove the name of the employee who was the victim of the workplace violence and enter "PRIVACY CONCERN CASE" in the space normally used for the employee's name. Privacy concern cases include cases involving: Injury or illness to an intimate body part or the reproductive system; Injury or illness resulting from a sexual assault; Mental illness; HIV infection; Needle stick injuries and cuts from sharp objects that are or may be contaminated with another person's blood or other potentially infectious material; and Other injuries or illnesses, if the employee independently and voluntarily requests that his or her name not be entered on the report.
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