Date:  Employee's Name: Department:
Title:     Date of Incident:

1. Has a verbal warning been given?

  • NoYes, the verbal warning was given on

2. Type of warning  

  • First written warning
  • Final written warning

3. Explain why this warning is being given (Additional information can be provided below).

4. Describe the employee's specific rule violation or performance problem:
  • :
  • :
  • :
  • :
  • :
  • :
  • :
  • :
  • :
  • :
  • :
  • :
  • :
  • :
  • :
  • :

5. Describe the change in behavior that is expected of the employee:

6. Describe the consequences if this behavior is not changed:

7. Employee statement or rebuttal:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

TO BE READ AND SIGNED BY THE EMPLOYEE:

The above problem(s) have been discussed with me, and I understand that failure to improve my performance or additional unsatisfactory behavior will result in further disciplinary action, up to and including suspension or termination. I understand that my signature does not necessarily signify agreement with the facts or actions stated. If I disagree, it is my option and responsibility to pursue an appeal as follows:

Employee's signature: ________________________________ Date: ____________________

-or-
Employee was asked to sign this written warning on   _______________   but declined to sign.

Witnessed by: ________________________________________ Date: ____________________
Name:
Title:

Supervisor's signature: _______________________________________ Date: _____________

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Employee Written Warning Form - Free Template

Handle employee relations professionally with our employee written warning form. Address violations, improve performance, and maintain a well-documented record.

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What's an employee written warning?

When an employee violates a company policy, a written warning helps you in two ways. It offers a means of disciplining the employee to improve their awareness and job performance, and it also creates documentation for the company should punishment or dismissal prove necessary in the future. Protect the integrity of your business with an employee written warning.

Here's the information you'll need to have handy to complete your employee written warning:
- Who it's going to : Know the employee's name and the department that will receive this disciplinary notice.
- Subject matter : Have details of the rule violation or performance issue handy.
- Dates : Be clear about the date of any specific incident and any previous warnings.
- Next steps : Clarify the future expectations of behavior for the employee, as well as further disciplinary means if behavior doesn't change.