Progressive Disciplinary Action Form printable pdf download

Progressive Disciplinary Action Form

To complete this form click on first gray area (field); tab to all succeeding gray areas (fields) until form is completed.

(Gray areas will expand when filling in)

Date:

Employee Name:

Department:

Notice of Verbal/Oral Warning

Notice of Administrative Reassignment

Notice of Written Warning

Notice of Termination

Notice of Decision-Making

Statement of the problem (violation of rules, policies, standards, practices or unsatisfactory performance):

Prior discussion or warning on this subject: (oral, written, dates):

Statement of company policy/master agreement on this subject:

Summary of corrective action to be taken (include dates for improvement and plan for follow-up):

Consequences of failure to improve performance or correct behavior:

Employee comments (continue on reverse if necessary):

Effective _______________ (date), you are placed on performance improvement. If, at any time after this

date, you fail to meet expectations or to make sufficient progress towards expectations, disciplinary action

may be escalated up to and including termination.

Distribution: One Copy to Employee, one copy to Supervisor. One copy to Human Resources for Written

Warning, Decision Making Day or Termination only.

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Progressive Disciplinary Action Form

Progressive Disciplinary Action Form