Employee Correction Notice

  • Date

  • Employee Name

  • Employee Position/Title

  • Supervisor

  • Supervisor Position Title

  • Disciplinary Level

Details/Reasons for Warning

  • Date of Incident

  • Type of Warning

  • Previous Warning

  • Type of Warning

  • Date of Previous Warning

  • Reason for this Warning

  • Current Incident Description

  • Date of this infraction:

  • Procedure/Policy Broken:

  • Witnesses Present:

  • Employee Statement

  • Corrective Action: Suspension

  • Corrective Action/Other:

Acknowledgement

  • Employee Acknowledgement: (an employee's refusal to sign does not invalidate this notice) By signing this notice, I acknowledge that I understand the document's contents and that I have been counseled of consequences if improvements are not made. I understand that failure to meet and sustain improved performance or additional violations of company policy will result in disciplinary action up to and including termination. I also acknowledge that my employment is at will and depending on the nature of the offense, the Company reserves the right to skip any steps at its discretion.

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  • Employee Signature

  • Date

  • Manager Signature

  • Date

  • Witness Signature

  • Date

  • Employee Refused to sign

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.