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RECORD OF EMPLOYEE COUNSELING - hbboys.com

RECORD OF EMPLOYEE COUNSELING NAME · POSITION STORE # This is to confirm in writing that you have been counseled for the reasons shown below: DISCIPLINARY ACTION

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Text of RECORD OF EMPLOYEE COUNSELING - hbboys.com

RECORD OF EMPLOYEE COUNSELINGNAME POSITIONSTORE #This is to confirm in writing that you have been counseled for the reasons shown below:DISCIPLINARY ACTION FOR:INSUBORDINATIONVIOLATION OF EMPLOYER RULESINTOXICATIONLEFT WORKPLACE WITHOUT PERMISSIONEXCESSIVE ABSENTEEISMCASH SHORTAGEEXCESSIVE TARDINESSPOOR WORK PERFORMANCEOTHER:DETAILS OF PERFORMANCE PROBLEM OR RULES VIOLATION:(BE SPECIFIC, INCLUDE DATES)Any future violations of Company policy will result in further disciplinary action, up to and including termination. DISCIPLINARY ACTION TAKEN:VERBAL WARNING WITH ADVICE ON HOW TO IMPROVEWRITTEN WARNING WITH ADVICE ON HOW TO IMPROVESUSPENSION AND/OR DISCIPLINARY PROBATION (FURTHER DISCIPLINE MAY RESULT IN YOUR DISCHARGE)TERMINATIONSUPERVISOR'S SIGNATUREDATE ISSUEDEMPLOYEE'S SIGNATUREDATE DISCUSSEDNOTE: Employee's signature indicates that this record of employee counseling has been discussed with the employee,and does not necessarily mean that the employee agrees with it. It does acknowledge receipt of a copy of the counselingrecord. The employee may write any comments on the back of this form for his/her personnel file. Revised 11/14

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