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Disciplinary/Counseling Report

Name
Time:
:
ACTION TAKEN
DESCRIPTION OF ISSUE:
(Depending on the nature of the offense, [Company Name] reserves the right to skip any steps at its discretion.)

GOALS/CORRECTIVE BEHAVIOR:

Should your record continue to be unacceptable in the above area(s), the company will find it necessary to take the following disciplinary action (or more depending on the situation):

EMPLOYEE COMMENTS

You are formally being warned to bring to your attention the severity of this situation. Failure to correct this behavior and/or further violation of company policy will result in additional disciplinary action up to and including discharge. By signing below you acknowledge that you have received this notice.

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