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Prevention and management of aggression in ... - WorkSafe Victoria

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ToolP7Conditions <strong>and</strong> agreement (cont)ONGOING ACCESS TO AND USE OF FACILITIESAND SERVICESStaff, clients <strong>and</strong> visitors <strong>of</strong> are entitled to a safeenvironment free <strong>of</strong> violence, threats <strong>and</strong> <strong>in</strong>timidation.THE CONDITIONSI, agree to treat all staff, clients <strong>and</strong> visitorscourteously <strong>and</strong> with respect at all times.I underst<strong>and</strong> that threats, <strong>in</strong>timidat<strong>in</strong>g behaviour, verbal abuse, physical violence<strong>and</strong> other anti-social behaviour are unacceptable.I accept that I will be restricted to the treatment area or ward where I ama client or visit<strong>in</strong>g.I agree to visit the hospital on only <strong>and</strong> between the hours <strong>of</strong> <strong>and</strong> <strong>and</strong> on every occasion I will report to the head<strong>of</strong> security at the reception desk on arrival before proceed<strong>in</strong>g to the treatmentarea or ward.I underst<strong>and</strong> that <strong>in</strong> certa<strong>in</strong> circumstances, a security guard will be based on theward dur<strong>in</strong>g my treatment or visit.I am aware that a request for <strong>in</strong>formation about a relative (if I am the next <strong>of</strong> k<strong>in</strong>)from a member <strong>of</strong> staff may be made through the patient liaison <strong>of</strong>ficer or afterhoursadm<strong>in</strong>istrator.I underst<strong>and</strong> that if I breach any <strong>of</strong> these conditions, security staff may evict mefrom the hospital <strong>and</strong>/or contact the police to enforce the eviction <strong>and</strong> obta<strong>in</strong>a restra<strong>in</strong><strong>in</strong>g order aga<strong>in</strong>st my return<strong>in</strong>g to this hospital..I AGREE TO THE CONDITIONS ABOVE AND AM AWARE THAT FAILURE TOCOMPLY WITH THESE CONDITIONS WILL RESULT IN MY EVICTION FROMTHIS HOSPITAL. I HAVE BEEN GIVEN A COPY OF THIS AGREEMENT.Signed:Page 2 <strong>of</strong> 280 H<strong>and</strong>book / <strong>Prevention</strong> <strong>and</strong> <strong>management</strong> <strong>of</strong> <strong>aggression</strong> <strong>in</strong> health services <strong>WorkSafe</strong> <strong>Victoria</strong>

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