Self Audit: Discipline Form 

The following material is based on a review of discipline forms. It is designed to assist in creating, modifying or auditing discipline forms. The material presented is initially divided into common divisions or sections that appear on many discipline forms. Listed under each of the common parts or sections are typical information and format used or an explanation of the section. 

The 11 basic sections are: 

• Form label 
• General information/data
• Directions/definitions
• Specific details of the infraction
• Any relevant past documentation
• Employee's perspective of the facts concerning the infraction
• Action to be taken
• Employee comments
• Signatures
• Approval
• Additional management and human resources review and comments

These sections do not have to follow in the order listed and several may be combined into one section. For administrative purposes, there may be a place to check off in a prominent position on the form itself that indicates that there are attachments.

 1. Form label 

• The form should be clearly labeled as a disciplinary action (ideally in a bold type larger than usual). Terms such as Employee Warning Record or Notice of Employee Reprimand can be used. The company name and logo should be prominently displayed. 

2. General information/data Information found in this section is about the employee and includes: 

• a. Employee's name
• b. Employee number
• c. Social security number
• d. Functional title/position title
• e. Organizational unit/department/shift
• f. Location
• g. Name of supervisor/leader 

3. Directions/definitions 

• Many forms offers printed instructions on completing the form on the first page of a multipage document. It is common for the important points of the company policy concerning disciplinary documentation to be included.

4. Specifics of the infraction. This section usually contains: 

• a. Time, date and location of infraction
• b. Names and titles of witnesses
• c. Nature of the infraction

It is common for the form to list with a checkoff space frequent types of infractions. If a list is included on the form, be sure to have an "Other" category with a space to describe the infraction. The list may include: 

It is common for these forms to include, in addition to a check off list of possible infractions, a blank space to write in the specifics or amplify the importance of the violation. Also double check how the employee knew that his or her behavior was subject to discipline, such as a notice in the handbook or a handout in orientation. 

5. Relevant past documentation 

• If the employee is on a written warning or some form of probation for past discipline, it is important to include that information in the documentation. The information in this section generally related to:
  • a. Current status i.e. probationary, discipline warning, active
  • b. Types of past violations
  • c. Dates of past violations
  • d. Previous action recommended
  • e. Name and title of person recording past violation 

Note. Only past violations that have been documented and that are relevant to the infraction being documented should be included in the documentation. If the prior violation was not documented at the time, then it should not be used in a subsequent situation. Likewise, if the prior documentation has no meaning or impact to the current situation, it is not appropriate to automatically include the information. Each situation requires objective review and judgment.

6. Employee's perspective of the facts concerning the infraction

• Typically, forms provide black space for the employee to document the employee's perspective of the situation. In addition to the space provided, the form may:
  • a. State that the absence of any employee statement indicates agreement with the facts as presented.
  • b. Provide a space to check whether or not the employee agrees with the facts stated in the documentation.
  • c. Indicate a space for employee signature and date.

7. Action to be taken 

• A blank space is provided for the person completing the form to indicate what action will be taken (or is recommended to be taken) as a result of the infraction. In addition, this segment should include space for the name, signature, title, date and location/telephone extension of the individual preparing the form.

 8. Employee comments 

• This place on the form may be provided, even if there is another area for the employee to provide input. This area provides a place for the employee to react to the discipline proposed as well as to other concerns or to indicate mitigating circumstances.

 9. Signatures 

The employee's signature, the signature of the individual completing the form, titles of both individuals and the dates signed should appear in this section. It is common for a variation of the following language to appear above the employee signature: My signature below acknowledges that I have been advised of the action to be taken as a result of this reprimand. I have read this warning and understand it.

 10. Approval 

• This information relates to the person or persons who reviewed the proposed action and approved it:
  • a. Signature
  • b. Printed name
  • c. Title
  • d. Date signed

Some disciplinary systems call for a next level management review and approval of the appraisal, especially if the warning is a final step prior to termination.

 11. Additional distribution and human resources review and comments

It is common to indicate to whom or where copies of the warning will be forwarded. Depending upon the company and the specific discipline policy, the distribution could include: 

• a. Employee
• b. Supervisor/leader/foreman
• c. HR department and/or personnel file
• d. Union representative
• e. Plant manager or department manager 

Reprinted with permission. © CCH