Employee Corrective Action Form

  • Instructions: The purpose of this form is to record coaching, verbal and written warnings as well as improved performance.
  • Please complete all applicable sections.

SECTION 2 : Type of Corrective Action

Type of Consultation:
Coaching (Memo to File)
Verbal Warning
Written Warning
Final Written Warning *
Performance Improvement Plan *
Separation *
Suspension (Leave Without Pay) / # of days: *
* HR consultation required

SECTION 3 : Statement of Situation

People Manager/Leader – describe the situation using specific examples.


Acknowledgement: I have reviewed the contents of this form with my manager. I understand that I have the option to provide my statement and (have or have not) chosen to state my comments in the section above; I am aware that my signature does not necessarily indicate agreement of the above contents.

Further violation of the Authority’s standards, policies and procedures may result in further disciplinary action up to and including separation.

(Required for Suspension/Demotion/Performance Improvement Plan)