Sample form for documenting employee disciplinary actions

Explanation.When you are required to take disciplinary action against an employee, it is essential to create and keep a good record of what steps have been taken. A good record will contain: details of the incident or conduct that led to the disciplinary action, the objective circumstances surrounding your meeting with the employee, and what you communicated regarding your expectations about the employee's future conduct.

Such a record can serve many purposes. If you have a workforce where disciplinary problems come with the territory, it can help you keep each employee's record straight. Use of a consistent format that demonstrates even-handed application of your policies can be strong evidence that your actions are not the result of discrimination. And, if an employee doesn't work out despite your best efforts, you will have built a substantial written case demonstrating why it was necessary to terminate the employee.

This simple form can be used to document the disciplinary action that you have taken. Remember that your records will be most useful if you promptly complete a disciplinary action form every time you have to take action, whether it takes the form of a conversation or a formal written notice.

Employee Information

Name of Employee: ___________________________________________________

Employee's Job Title: __________________________________________________

Incident Information

Date/Time of Incident: _________________________________________________

Location of Incident: __________________________________________________

Description of Incident: _________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

Witnesses to Incident: ___________________________________________________

Was this incident in violation of a company policy? ___________________________

If yes, specify which policy and how the incident violated it. ____________________

_____________________________________________________________________

_____________________________________________________________________

Action Taken

What action will be taken against the employee? ______________________________

____________________________________________________________________

____________________________________________________________________

Has the impropriety of the employee's actions been explained to the employee? ______

Did the employee offer any explanation for the conduct? If so, what was it? __________

____________________________________________________________________

____________________________________________________________________

Signature of person preparing report: _________________________________________

Date: ___________________________________________________________________