Employee Incident Report

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Employee Incident Report
Date
Employee
Manager
Name
Name
Title/position
Title/position
Incident
Date
Time
Location
Description of incident
Employee explanation
Witnesses
Action to be taken
Verbal warning
Probation
Dismissal
Written warning
Suspension
Other
Explain
By signing this document, you acknowledge that you have read and understood the
information contained herein
Employee
Manager
Date
Date

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