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DISCIPLINE DOCUMENTATION NOTICE
Employee Information
Name:
Job Title:
Department:
Incident Information
Date/Time:
Place:
Description:
Witnesses:
Was this incident a violation of a company policy? Yes No
Standard operating procedure? Yes No
A management order? Yes No
If yes, specify which policy or procedure and how the incident violated it.
Next Steps
What actions have been taken in the past when incidents like this occurred?
What action will be taken against this employee?
Has the problem with the employees actions been discussed with the employee? Yes No
Did the employee offer any explanation for the incident? Explain.
Signature of manager preparing report:
Date:
Any employee rebuttal:
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