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Disciplinary Action Form Template

Disciplinary Action Form Template

What Disciplinary Action Form Template consists of?

The Disciplinary Action Form Template is a document used by employers to record instances of employee misconduct or poor performance. It includes employee details, date, and time of the incident, along with a brief description of the misconduct. This form serves as a formal record and may be used in the disciplinary process.

Template

[Company Name]

[Date]

Disciplinary Action Form

Employee Information:

Description of Incident:
[Provide a detailed description of the incident or behavior that led to the disciplinary action. Include dates, times, locations, witnesses, and any relevant information.]

Previous Discussions and Warnings:
[Specify any previous discussions, verbal warnings, or written warnings related to the employee’s behavior or performance.]

Violated Policies or Expectations:
[Identify the company policies, rules, or performance expectations that the employee has violated.]

Disciplinary Action Taken:
[Select the appropriate disciplinary action taken from the following options:]

Disciplinary Action Details:
[Provide additional details about the disciplinary action, including the date of the action, the person responsible for implementing the action, and any conditions or requirements for improvement.]

Employee’s Response:
[Allow the employee to provide their response to the disciplinary action. Include a section for the employee to acknowledge receipt of the form.]

Action Plan and Follow-Up:
[If applicable, outline any action plan or performance improvement plan for the employee to follow. Specify a timeline for improvement and any support or resources provided to help the employee meet expectations.]

Employee Acknowledgment:

I, [Employee Name], acknowledge that I have received a copy of this Disciplinary Action Form and understand the details of the disciplinary action being taken. I have had the opportunity to discuss the incident and the disciplinary action with my supervisor.

Employee’s Signature: [Employee’s Signature]

Date: [Date]

Supervisor’s Comments:

[Supervisor’s comments on the disciplinary action, including any additional instructions or support provided to the employee.]

Supervisor’s Signature: [Supervisor’s Signature]

Date: [Date]

HR Representative’s Comments:

[HR representative’s comments on the disciplinary action, including any additional information or follow-up steps.]

HR Representative’s Signature: [HR Representative’s Signature]

Date: [Date]

Witness (if applicable):

Final Notes:
[Add any additional comments, remarks, or notes related to the disciplinary action.]

This Disciplinary Action Form will be placed in the employee’s personnel file for record-keeping purposes. All parties involved should retain a copy of this form for their records.

[Company Name] is committed to providing a fair and respectful workplace for all employees. We expect all employees to adhere to company policies and performance standards to maintain a positive work environment.

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