Verbal Warning Form

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VERBAL WARNING FORM
Issued By: ______________________
Employee: ______________________
Date: _______________
This from is being completed to document a verbal warning issued to you on the above
date.
The reason for the warning is:
If there are additional incidents, we may impose further disciplinary actions up to and
including dismissal.
_________________________
_______________
Employee Signature
Date
_________________________
_______________
Supervisor Signature
Date

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