Progressive Discipline Warning Form

The Warning Form Documents the Employer's Counseling and Expectations

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Disciplinary action is sometimes necessary when an employee's behavior is negatively impacting his or her work or his or her coworkers' work. In general, making the workplace less effective, harmonious, or productive is enough reason for an employer to begin progressive disciplinary action.

The discipline warning is a tool that an employer uses to get an employee's attention. It generally proceeds by a series of meetings between the employee and their manager. During these meetings, the manager coaches and counsels the employee in an effort to improve the employee's performance.

The disciplinary action is taken when the result of these meetings is not improved employee performance. Employers hope that by documenting the poor performance and the suggestions for improvement that they will get the employee's attention in a way that counseling has not achieved.

Employers need to remember that while other employees may know that the employee receiving a disciplinary warning is in trouble - usually because the employee tells them - they must honor employee confidentiality. From the employer's perspective, no communication with staff can occur.

Preparing the Disciplinary Action Form

The disciplinary warning form is prepared in advance of the manager and the employee meeting. It is usually written with the assistance of Human Resources staff who are experienced in documenting employee performance. A form similar to this sample is used or a formal letter is written to the employee. Either work.

Managers may only have to write a disciplinary warning every few years and so they are inexperienced in the practice. HR, on the other hand, monitors all employee disciplinary action. HR staff ensures that employees are treated fairly, ethically and similarly for the same transgressions. They ensure the legality of the writeups and often run them by an employment law attorney for advice.

When the manager schedules the disciplinary action meeting, it is also customary for the HR staff `person to attend. HR serves as a witness and also steps in when the manager loses his way. This is normal when managers lack experience in formal discipline procedures.

This disciplinary warning form documents the discipline warning. This disciplinary warning form also documents and records the coaching or counseling discussion that accompanied the discipline warning.

Progressive Discipline Sample Warning Form


Employee Name:_____________________________






Reason for Disciplinary Action: (Check all that apply.)

___ Quality ___Productivity  ___ Safety ____Conduct ___ Attendance

____ Insubordination ___ Housekeeping ___ Miscellaneous

You are receiving this disciplinary warning because of the following actions. (Describe in detail in behavioral terms.)

Unless this problem is corrected, further disciplinary action will be taken up to and including the termination of your employment. (Check the appropriate step in the progressive discipline policy.)

_____ Written Verbal Warning

_____ Written Warning

_____ 1-Day Suspension OR

_____ 3-Day Suspension OR

_____ 5-Day Suspension OR

Supervisor’s Signature: __________________________________

Date: _______________

I have received this disciplinary action and understand that unless this problem is corrected, further disciplinary action will be taken up to and including the termination of my employment.

Employee’s Signature: ___________________________________

Date: _______________

Human Resources Representative Signature: _________________

Date: _______________

Counseling Discussion Plan

Describe the behavior that caused the need for this disciplinary action.

Describe the outcome or result of this behavior. (How is productivity affected; work impacted; employees affected or inconvenienced; cost impacted as a result of the behavior, etc.)

Describe the desired and expected  behavior.

Employee Statement. (Describe any assistance needed to improve.)

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