Employee Corrective Action / Write-Up Form
Documented, consistent, and boring is what you want here. Facts and dates, the policy involved, what has to change, and a signature — no adjectives.
Built for PPO owners and supervisors documenting attendance, conduct, or performance issues. · Updated 2026-08-01
PPO #122730How to use it
- 1.Write it the same week the issue happens; late documentation reads as pretext.
- 2.State only observable facts with dates and times — not characterizations.
- 3.Cite the specific policy or post order involved and attach it.
- 4.Define the expectation and the review date in writing so 'improved' is measurable.
- 5.Have the employee sign; if they refuse, note the refusal and have a witness sign instead.
Employee and incident
Employee name, position, post
Date of this notice and date(s) of the conduct
Level
Verbal documented / written warning / final warning
Prior related notices and dates
Facts and policy
What happened — facts, dates, times, locations
Policy, post order, or standard involved
Cite the section and attach it
Impact on the client, the post, or the team
Expectations and acknowledgment
Required corrective action and deadline
Support offered
Retraining, shadow shift, schedule adjustment
Consequence if the issue continues
Follow-up review date
Employee comments
Employee signature / date (signature acknowledges receipt, not agreement)
Supervisor signature / date
Witness if employee declines to sign
Important notice
This is a working template, not legal advice, and it is not endorsed by BSIS, the Department of Consumer Affairs, or any other agency. Laws and regulations change — verify current requirements with the relevant agency and have your own counsel review any agreement before you sign or issue it.
Free resource from Summit Force Security Group, PPO #122730. This document is general information, not legal, insurance, or compliance advice, and it is not endorsed by any government agency. Requirements change: confirm current rules with your insurer, association counsel, or the relevant agency before you rely on it.
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