Employee’s Name: ____________________ Date: ______
Department: __________________________ Date of Incident: __
- Has a verbal warning been given?
Yes____ No _ If yes, date(s) of verbal warning(s) ___________________ - Type of warning
□ First written warning
□ Final written warning - Explain why this warning is being given. Check all that apply (Additional information can be provided below).
- Describe the employee’s specific rule violation or performance problem:
- Describe the change in behavior that is expected of the employee:
- Describe the consequences if this behavior is not changed:
- Employee statement or rebuttal:….
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