Disciplinary Notice

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									This Disciplinary Notice is intended to be used by an employer as a part of its
disciplinary program. This notice should be used as a procedure to preserve a record of
an employee's non-performance or misbehavior in the workplace. It also offers the
employee ways to improve performance or correct behavior. Documentation of
employee discipline is important for fairly informing an employee of performance
problems and for creating a trail of documentation for potential legal actions. This notice
is useful to companies when dealing with employees with performance or behavioral
issues.
                                     DISCIPLINARY NOTICE




Employee Name: ________________________

Department: ____________________________

Position: _______________________________

[Instruction: Insert the description of the employee]

Date of Incident: _____ [Month] _____ [Date], 20_____.

[Instruction: Insert the type of warning and mark “X” next to the applicable clause]

                            ______Written Warning       _____Final Warning

1. STATEMENT OF THE PROBLEM:
    ______________________________________________________________________________
    ______________________________________________________________________________
    _____________________________________________________________________
    [Instruction: Insert the type of problem and act of employee, E.g., violation of rules, policies,
    standards, practices or unsatisfactory performance.]

2. PRIOR           DISCUSSION          OR       WARNINGS           ON        THIS        SUBJECT:
    __________________________________________________________________________
    ______________________________________________________________________________
    ________________________________________________________________________

    [Instruction: Insert any prior oral or written, discussion or warning on this subject.]

3. STATEMENT               OF      COMPANY          POLICY          ON       THIS        SUBJECT:
    __________________________________________________________________________
    ______________________________________________________________________________
    ________________________________________________________________________

    [Instruction: Insert company policy on the act of employee.]


© Copyright 2012 Docstoc Inc.                                                        2
4. SUMMARY               OF     CORRECTIVE            ACTION         TO        BE       TAKEN:
    __________________________________________________________________________
    ______________________________________________________________________________
    ________________________________________________________________________

    [Instruction: Insert summary of corrective action to be taken including dates for
    improvement and plans for follow up]

5. CONSEQUENCES OF FAILURE TO IMPROVE PERFORMANCE OR CORRECT
    BEHAVIOR:
    __________________________________________________________________________
    ______________________________________________________________________________
    ________________________________________________________________________

    [Instruction: Insert penalty for failure to improve performance or correct behavior]

6. EMPLOYEE COMMENTS:
    __________________________________________________________________________
    ______________________________________________________________________________
    ________________________________________________________________________




__________________________________                _____ [Month] _____ [Date], 20_____

[Instruction: Insert signature of employee]

___________________________________               _____ [Month] _____ [Date], 20_____

[Instruction: Insert signature of supervisor]

Distribution: One Copy to Employee, one copy to Supervisor and original copy to

Personnel File.




© Copyright 2012 Docstoc Inc.                                                       3

								
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