---
title: Community Violence Interruption Incident Tracking Form Template | Paperform
description: Professional incident tracking form for violence prevention programs. Document shootings, assaults, mediation attempts, and retaliation prevention strategies with this comprehensive template.
url: "https://paperform.co/templates/community-violence-interruption-incident-tracker"
type: static
generatedAt: "2026-03-28T00:43:26.676Z"
---

[← Back to free form templates](/templates/)    ![Community Violence Interruption Incident Tracker](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/community-violence-interruption-incident-tracker.png)
    [Preview](https://_preview.paperform.co/ai-template/community-violence-interruption-incident-tracker) [Use this template for free](/create?ai-template=community-violence-interruption-incident-tracker)    [Nonprofit & Charity](/templates/category/nonprofit/) [Nonprofit](/templates/industry/nonprofit/) [Social Worker](/templates/role/social-worker/)[Nonprofit Director](/templates/role/nonprofit-director/)[Program Coordinator](/templates/role/program-coordinator/)     About this free form template
Violence interruption programs play a critical role in breaking cycles of community violence, preventing retaliation, and saving lives. This **Community Violence Interruption Incident Tracker** template helps frontline workers, outreach teams, and program coordinators document incidents, track mediation efforts, and implement evidence-based retaliation prevention strategies.

Designed specifically for nonprofit violence prevention programs, community safety initiatives, and street outreach organizations, this form captures essential incident intelligence including location data, victim and offender information, conflict history, and intervention attempts. The structured format ensures your team can quickly log critical details in real-time while maintaining confidentiality and security protocols.

The template includes dedicated sections for shooting and assault documentation, witness and intelligence gathering, mediation attempt tracking, and retaliation risk assessment. This comprehensive approach helps your program build a complete picture of community violence patterns, identify high-risk situations, and deploy targeted prevention strategies before conflicts escalate.

**Streamline your violence prevention workflow** by connecting this form to your case management system using [Stepper](https://stepper.io). Automatically route high-priority incidents to your rapid response team, trigger follow-up tasks for outreach workers, send alerts when retaliation risk is elevated, and keep your program director informed of critical developments without manual data entry.

Whether you're running a hospital-based violence intervention program, community-based street outreach initiative, or municipal violence prevention office, this template provides the structure and detail needed to track incidents effectively, demonstrate program impact, and ultimately interrupt the cycle of violence in your community. The form is designed with the unique needs of violence interrupters in mind—those who work directly with individuals involved in violence to mediate conflicts and prevent future incidents.
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