Employee Disciplinary Action Form Template
A free employee disciplinary action form for managers and HR. Record the issue, warning level and plan, and the employee signs to acknowledge it.
Customize the pages and design to fit your needs.
About this template
Document a verbal, written or final warning in one employee disciplinary action form. Record what happened, past warnings, the improvement plan and the employee's comments, then save a signed PDF for the file.
Common uses
- Managers documenting warnings
- HR teams and small businesses
- Retail, restaurant and shift teams
Key features
- Warning level and issue type
- Improvement plan and review date
- Signed employee acknowledgment
What this template asks
What's the employee's full name?
Short Text
What's the employee's work email?
Email
What's the employee's job title and team?
Short Text
Who is issuing this notice?
Short Text
When did the issue happen?
Date
What type of issue is it?
Multiple Choice · Attendance or lateness, Performance, Conduct, Policy violation, Safety, Something else
Which level of warning is this?
Single Choice · Verbal warning, Written warning, Final warning, Suspension
Describe what happened
Long Text
List any earlier warnings
Long Text · Optional
What needs to change, and by when?
Long Text
Does the employee want to add their side?
Long Text · Optional
Employee acknowledgment
Agreement text, accepted with “I agree”
Sign to acknowledge this notice
Signature
How to use this template
Copy it
Select Use template and a copy opens in your workspace as an unpublished draft.
Make it yours
Edit any question or answer, choose a theme, and add your logo.
Share it
Publish, then send the link, show a QR code, or embed the form on your site. Responses arrive in Submissions.
Employee acknowledgment
Signers read this text in the form before they accept it. Edit the bracketed details to match your business, and have the wording reviewed for your situation.
Please read this before you sign.
This notice is from [Company name] (the "Company") to the employee named in this form.
- Signing means received. Your signature shows that you received and read this notice. You can add your side in the comments above.
- Your side. You can add comments above, and they are kept with this notice.
- Next steps. If the issue continues, the Company may take further action under [policy name], up to and including termination.
- Review. Your manager will review progress with you on or before [review date].
- Records. A copy of this notice is kept in your personnel file.
By signing below, I confirm that I received this notice and had the chance to comment.
Frequently asked questions
What should an employee disciplinary action form include?
The employee, the date and type of issue, the warning level, what happened, any earlier warnings, what needs to change by when, and the employee's comments and signature.
Does the employee's signature mean they agree?
No. The acknowledgment says signing only shows they received the notice. They can add their side in the comments.
How do managers use it in a meeting?
Fill it in before the meeting, then hand the device to the employee to read, comment and sign. The signed PDF is saved for the employee file.