Teammate Disciplinary Action
Date
*
-
Month
-
Day
Year
Date
Office
Please Select
Bell
43rd
PCH
Teammate Name
*
Last Name
First Name
Type of Violation
*
Poor performance
Absences/Tardiness
Violation of Tooth Club Policy
Insubordination
Harrasment
Safety Violation
Other
Disciplinary Action Taken:
*
Please Select
Verbal Warning
Written Warning
Suspension
Terminations
Brief Information About Violation:
*
Follow Up Date:
*
-
Month
-
Day
Year
Date
Teammate Signature
*
Manager Signature
*
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