Employee Coaching Form
Documentation of concerns, issues or incidents involving:

Please specify

Describe performance concern or issue (be specific, and include dates and examples)

Describe agreed upon solution(s) or course of action

Follow-up review plan date
Full Name and Signature of the Employee
Full Name and Signature of the Supervisor or Manager
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.