Employee Counseling Form

Information you will need

• What’s the name of the employee's supervisor?
• What's the counseling date?
• What’s the name of the employee?
• What’s the employee's department?
• What’s the employee's title?
• What's the employee's work ID number?
• Is the counseling due to attendance issues?
• Is the counseling due to dress code issues?
• Is the counseling due to peformance issues?
• Is the counseling due to behavioral issues?
• Is the counseling due to teamwork issues?
• Is the counseling due to safety issues?
• Is the counseling due to violence?
• Is the counseling due to a reason not listed here?
• What's the counseling reason?
• When did the incident happen?
• What are the details of the incident?
• What corrective actions must be taken by the employee?
• What are the employee's comments regarding the incident? (if any)
• What’s the name of the witness?

Completed by the employee.

The form includes a witness section.