Confirmation Verbal Warning Form

							     CONFIRMATION OF EMPLOYEE VERBAL WARNING FORM
From: _________________________________           Date: _____________________________
                   Name
Department: ____________________________          Position: ___________________________

Regarding: _____________________________          Position: ___________________________
               Employee Name
Department: ____________________________



1.     I have made the following observation of employee’s conduct/work performance:
       _______________________________________________________________________
       _______________________________________________________________________
       _______________________________________________________________________


2.     I have informed employee of the following standards which will be expected of him/her
       in the immediate future:
       _______________________________________________________________________
       _______________________________________________________________________
       _______________________________________________________________________


3.     I have advised employee of the following consequences of he/she fails to follow the
       above-standards:
       _______________________________________________________________________
       _______________________________________________________________________
       _______________________________________________________________________


Signature: ____________________________________
                     Supervisor


I acknowledge the above verbal warning was delivered to me as stated above and understand if
these issues are not resolved, additional steps, including termination, may be necessary.

Employee Comments: ___________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________


Signature: ____________________________________           Date: ________________________
                      Employee