VERBAL CORRECTIVE ACTION REPORT
Employee Name ______________________________________ Date ________________________
Job Title ______________________________________ Department __________________
A verbal warning was issued to the above named employee this date by reason(s) of the following; improper
conduct, violation of an established rule, unsatisfactory work performance, or other cause as explained below.
( ) ABSENTEEISM ( ) MISCONDUCT
( ) ABUSIVE LANGUAGE ( ) TIME CLOCK INFRACTION
( ) IMPROPER DRESS ( ) UNSATISFACTORY WORK PERFORMANCE
( ) IMPROPER USE OF EQUIPMENT ( ) TARDINESS
( ) INSUBORDINATION ( ) OTHER
Explanation of violation: _____________________________________________________________________
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Corrective Action Taken: _____________________________________________________________________
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Employee’s reaction to verbal correction: ________________________________________________________
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Additional Comments: _______________________________________________________________________
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Supervisor’s Signature _____________________________________ Date __________________
Employee Signature (Optional) _______________________________ Date __________________
CC: Human Resources Revised 4/15