EMPLOYEE COUNSELING FORM - RACKING | Single Source Systems Inc.

EMPLOYEE COUNSELING FORM - RACKING

Foreman's Name(Required)

Your Email(Required)

Counselling Date(Required)

Employee's Name(Required)

First Last

Location(Required)

Job Title

This counseling is being issued because of the following (Select all that apply):

Attendance

Behavior/Teamwork

Inappropriate Conduct

Inappropriate Attire

Safety Violations

Sleeping on the Job

Substandard Work

Violence

Other

Describe the nature of the incident (if applicable):

Corrective Action:

Additional Comments:

This form is intended to help direct the employee onto a successful path in the work place. It is important to make immediate and sustained improvement and the failure to do so could result in further disciplinary action, up to and including termination of employment. Note: Your signature on this form means that we have discussed the situation. It doesn’t necessarily mean you agree that the infraction occurred.

Employee’s Signature(Required)

Print Employee's Name(Required)

Date(Required)

Supervisor’s Signature(Required)

Print Supervisor's Name(Required)

Date(Required)

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