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Employee Disciplinary Action Form
Record employee misconduct, corrective measures, and performance improvement plans with this Employee Disciplinary Action Form Template.
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EMPLOYEE DISCIPLINARY ACTION FORM TEMPLATE
This Employee Disciplinary Action Form (“Form”) is issued by [Company Name], effective as of [Date], to formally document disciplinary actions taken in response to employee misconduct or performance issues.
1. Employee Information
Employee Name: ___________________________
Position/Department: ______________________
Supervisor: _______________________________
Date of Incident: __________________________
Date of Report: ____________________________
2. Type of Violation
☐ Attendance/Tardiness
☐ Insubordination
☐ Performance Issues
☐ Safety Violation
☐ Misconduct/Behavior
☐ Policy Violation
☐ Other: _______________________________
3. Description of Incident
Provide a detailed, factual description of the incident or violation, including relevant dates, times, witnesses, and actions observed:
4. Previous Warnings (if applicable)
☐ Verbal warning issued on [Date]
☐ Written warning issued on [Date]
☐ Prior suspension on [Date]
Details: _____________________________________________________________
5. Corrective Action Taken
☐ Verbal Warning
☐ Written Warning
☐ Final Warning
☐ Suspension (Duration: ___________)
☐ Termination
☐ Performance Improvement Plan (attach copy)
Summary of corrective action:
6. Employee Response
(Employee may provide written comments or explanation related to the incident or corrective action.)
7. Acknowledgment
By signing below, the employee acknowledges receipt of this disciplinary action form. The signature does not necessarily indicate agreement with the decision.
Employee Signature: ________________________ Date: ____________
Supervisor/Manager Signature: _______________ Date: ____________
HR Representative Signature: ________________ Date: ____________
8. Follow-Up and Review
A follow-up review will be conducted on [Date] to evaluate employee progress and determine if further action is required.
Reviewer Name: __________________________
Position: ________________________________
Date of Review: __________________________
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Employee Disciplinary Action Form
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For quick answers, scroll below to see the FAQ.
EMPLOYEE DISCIPLINARY ACTION FORM FAQ
What is an Employee Disciplinary Action Form?
An Employee Disciplinary Action Form is an official record used by employers to document performance issues, misconduct, or policy violations, along with corrective actions and follow-up steps.
Why is an Employee Disciplinary Action Form important?
It provides a transparent and consistent process for addressing employee issues, supports fair treatment, and helps protect the employer in case of legal disputes. Proper documentation ensures compliance with HR policies and labor laws.
When should this form be used?
Use it whenever an employee violates company policy, exhibits repeated poor performance, or engages in behavior that disrupts workplace operations. It should also be used to track corrective steps and improvements over time.
What should an Employee Disciplinary Action Form include?
It should include employee details, description of the incident, type of violation, disciplinary actions taken, employee acknowledgment, and follow-up review plans. This ensures clear communication and accountability.
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