Team Member Record of Discussion

Team Member Record of Discussion
Employee name
Employee ID
Division
Date of Discussion

MonthDayYear
Date
Submitted by
Reason for Discussion
Summary of Discussion (Please describe what was said during discussion)
Provide a detailed summary of the discussion - include specific issue or situation, key points, how the conversation concluded.
Action Taken
Continued issues will lead to further corrective action up to and including termination.
Acknowledgements

My signature confirms this discussion took place.
Team Member Signature

Clear
Supervisor Signature

Clear
Should be Empty:

Acknowledgements