We systematically studied femtosecond laser-inscribed self-organized nanogratings and geometric phase elements such as a polarization diffraction focusing lens and Q-plate in sapphire crystal. Besides the void structures observed in the focus, nanogratings with periods of 150~300 nm were observed, depending on a nanoslit that took the role of a seeding effect by localized light field enhancement. The non-polarized refractive index change and birefringence were measured with values around 1∼2×10-3 and 6×10-4, respectively. Based on the laser-inscribed form birefringence, a geometric phase lens and Q-plate were successfully demonstrated in sapphire with high imaging and a focusing effect. We expect that our findings may promote the understanding of laser-induced nanogratings in bulk and potential applications in geometric phase elements.