Employee Discipline Documentation Form
Name of Person Requiring the Documentation
*
First Name
Last Name
Date of Infraction
*
-
Month
-
Day
Year
Date Picker Icon
Time of Infraction
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
05
10
15
20
25
30
35
40
45
50
55
Minutes
AM
PM
AM/PM Option
Describe the Infraction and any action taken to stop it from continuing
*
Name of person filling out this report
First Name
Last Name
Submit
OFFICIAL USE ONLY - Disciplinary Action Taken
This section is to be filled out when the final disciplinary action is taken.
Supervisor Signature / Date
Employee Signature / Date
Should be Empty: