# 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.

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.

Canonical: https://reuily.com/templates/disciplinary-action-form
Use this template: https://reuily.com/form/from-template/disciplinary-action-form
Collections: Applications & HR, Human Resources, Operations
Last updated: 2026-10-24

## Questions

- Question 1: What's the employee's full name? (Short Text, required)
- Question 2: What's the employee's work email? (Email, required)
- Question 3: What's the employee's job title and team? (Short Text, required)
- Question 4: Who is issuing this notice? (Short Text, required)
- Question 5: When did the issue happen? (Date, required)
- Question 6: What type of issue is it? (Multiple Choice, required). Options: Attendance or lateness; Performance; Conduct; Policy violation; Safety; Something else
- Question 7: Which level of warning is this? (Single Choice, required). Options: Verbal warning; Written warning; Final warning; Suspension
- Question 8: Describe what happened (Long Text, required)
- Question 9: List any earlier warnings (Long Text, optional)
- Question 10: What needs to change, and by when? (Long Text, required)
- Question 11: Does the employee want to add their side? (Long Text, optional)
- Agreement: Employee acknowledgment, accepted with "I agree" (full text below)
- Question 12: Sign to acknowledge this notice (Signature, required)

Signing records the signer's consent, email, IP address, browser and signing time, and each signer can download a signed PDF copy.

## Employee acknowledgment

Please read this before you sign.

This notice is from **[Company name]** (the "Company") to the employee named in this form.

1. **Signing means received.** Your signature shows that you received and read this notice. You can add your side in the comments above.
2. **Your side.** You can add comments above, and they are kept with this notice.
3. **Next steps.** If the issue continues, the Company may take further action under **[policy name]**, up to and including termination.
4. **Review.** Your manager will review progress with you on or before **[review date]**.
5. **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.

## 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

## 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.