Performance Documentation Form
Employee Name
*
First Name
Last Name
Employee Job Title:
*
Date of Occurrence:
*
-
Month
-
Day
Year
Date
Supervisor:
*
First Name
Last Name
Policy Violation:
Prior Occurrences Below:
HR FILLS OUT BELOW
Date:
Blank
Level of Action:
Blank
Violation of
Blank
Policy
Date:
Blank
Level of Action:
Blank
Violation of
Blank
Policy
Date:
Blank
Level of Action:
Blank
Violation of
Blank
Policy
Date:
Blank
Level of Action:
Blank
Violation of
Blank
Policy
Date:
Blank
Level of Action:
Blank
Violation of
Blank
Policy
CURRENT ACTION BEING TAKEN
*
Coaching/Counseling
Verbal Warning
Written Warning
Suspension (without pay)
Termination
FACTS:
*
OBJECTIVE:
*
SOLUTION(S):
*
ACTION TAKEN:
*
COMMENTS:
Re-evaluation or Follow up Needed with staff member?
Yes
No
Other
Re-evaluation meeting with Supervisor scheduled for Date
-
Month
-
Day
Year
Date
FACTS - List only facts, not opinions. Give concrete examples, when possible, to document the incorrect behavior. How is the event defined as a violation of company policy? What policy was violated? Be specific.
OBJECTIVES - What is the desired outcome? What are the expectations/standards of the company? You may want to cite a portion of the job description or a policy?
SOLUTIONS - How do you suggest that he or she improves their performance? Does the employee have any suggestions? You may offer additional training, review of procedures, etc.
REVIEW - All corrective actions should be reviewed by the HR Manager before the action is taken.
MEETING The HR Manager or another member of upper Management should be present when a corrective action is given to an employee.
ACTION - Tell the employee in writing that he or she is receiving a warning, suspension, etc. and set a date to review his or her progress towards obtaining the goals set.
SIGNATURES
PLEASE SCROLL DOWN AND SUBMIT FORM. SIGNATURES WILL BE REQUIRED TO SIGN AFTER HR HAS REVIEWED & APPROVED FORM
Submit
Employee
First Name
Last Name
Employee Email
example@example.com
Signature
Supervisor/Manager:
*
First Name
Last Name
Supervisor Email
example@example.com
Signature
*
HR Manager:
First Name
Last Name
HR Email
example@example.com
Signature
Note: A copy of this corrective action will be placed in the employee's personnel file for reference.
Should be Empty: