Disciplinary Action 

The purpose of disciplinary action is to correct the employee's behavior, maintain a productive work environment, and ensure that employees understand and adhere to company policies. Disciplinary actions can range from verbal warnings to more severe consequences, depending on the nature and severity of the misconduct. With this form managers are to submit any verbal or written communication to an employee about a behavior that needs to be changed and document the agreement made with the employee.

1. Employer Statement of Incident Describe the incident, including dates and times of when it occurred and whether it was a violation of policy, unsatisfactory performance, or something else. Include names of all involved parties.

2. Date of Incident

3. Time of Incident

4. Prior Warning(s) Related to this Incident

   Please add dates of any warnings given to the employee in the past related to this incident, and note whether each warning was verbal or written.

5. Summary of Performance Expectations

   Describe specific requirements that the company expects of the employee to improve performance to an acceptable level.

6. Consequences of Failure to Improve Performance or Correct Behavior

   What actions are you taking as a manager to assist the employee with any reasonable ways to meet the company’s requirements.