Employee Disciplinary Action Form

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A Disciplinary Action Resignation Letter is a formal letter between an employee and an employer acknowledging resignation in light of disciplinary measures. It is used to end employment respectfully and record the circumstances for HR purposes.
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Written by Karyna Pukaniuk - Reviewed by Kate Adkham

A Disciplinary Action Form Sample

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This guide provides a comprehensive overview of disciplinary actions, including a best-in-class template you can use with Loio. We will cover the legal importance of documentation, what to include in a disciplinary action form template, and the correct way to discipline an employee using a progressive model.

Edit, eSign, and download a professionally crafted and reviewed disciplinary action form PDF. 

When to Use a Disciplinary Action Form

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A formal disciplinary action form is not for every minor issue. It should be reserved for situations that require official documentation. Here are some situations where you might need one:

  • Repeated Misconduct: When an employee continues a behavior after receiving a verbal warning or informal coaching.
  • Serious Violations: For a single, significant offense that breaches major company policy, such as insubordination, a safety violation, or harassment.
  • Persistent Performance Issues: When an employee's work quality or productivity does not improve after being given clear feedback and support.
  • Clear Policy Breaches: To formally record and address any direct violation of written company policies outlined in the employee handbook.

Why Does Documentation Matter in At-Will Employment and What Are Its Limits?

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Many employers operate under the principle of "at-will" employment, which means an employer can terminate an employee for any reason, at any time, as long as the reason is not illegal. However, this does not provide absolute protection.

An employee cannot be terminated for illegal reasons, such as discrimination (based on race, religion, gender, age, disability, etc.) or as retaliation for a protected activity (like reporting harassment or whistleblowing).

This is where the employee disciplinary action form creates a clear, time-stamped record proving that disciplinary actions were taken for legitimate business reasons — such as poor performance or a specific violation — and not for discriminatory or retaliatory purposes. Proper documentation is your primary defense against claims of unfair treatment or wrongful termination.

What Are the Key Elements of a Disciplinary Action Form?

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The Loio disciplinary action form template includes all necessary sections to ensure all the required information is captured and the structure is clear.

  • Employee & Manager Information: Includes the name of the employee, position, and department, as well as the direct supervisor’s name and title.

  • Date of Report and Incident: The date the form is being filled out and the specific date(s) and time(s) the violation occurred.

  • Type of Violation: A checkbox or field to specify the nature of the issue (e.g., Attendance, Safety, Conduct, Performance).

  • Description of the Incident: A detailed, objective, and factual account of the event. This section must be unbiased and free of personal opinions.

  • Investigation Summary: A brief outline of the steps taken to investigate the incident, including who was interviewed.

  • Witnesses: Names and titles of any witnesses to the incident, if applicable.

  • Company Policies Violated: A specific reference to the policies and procedures from the Employee Handbook that were broken.

  • Previous Disciplinary Actions: A summary of any prior verbal warning or written warning for similar issues.

  • Corrective Action Plan: A clear description of the required changes in behavior or performance. This plan should set measurable goals and a timeline for the employee to correct their behavior.

  • Manager Comments: A separate section for the supervisor to add context or summarize the discussion.

  • Consequences of Failure to Improve: This section explicitly states the action taken if the employee does not improve (e.g., "Further disciplinary actions, up to and including a final warning, suspension, or termination").

  • Employee Comments: A dedicated space for the employee to provide their own written account or to dispute the manager's statement.

  • Signatures: The signature of the employee, manager, and an HR representative or witness. The employee's signature acknowledges receipt, not agreement.

  • Distribution List: A note indicating who receives a copy of the form (e.g., Employee, Personnel File, Manager).

How to Write a Disciplinary Form

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When you document an incident, the language you use is critical. To ensure the form is professional and defensible, follow these best practices:

  • Be Objective and Factual: Stick to the facts. Describe the behavior, not the person. Instead of "John has a bad attitude," write "On August 3rd, John told a client, 'That's a stupid question,' which violates our professional conduct policy."
  • Reference Specific Policies: Always link the misconduct to a specific rule in your employee handbook. For example, "This action violates Section 3.1 of the Employee Handbook regarding workplace attendance."
  • Avoid Emotional Language: The form should be free of accusations, sarcasm, or personal opinions. Maintain a neutral and professional tone throughout the document.
  • Be Clear and Specific: Vague statements like "improve performance" are not helpful. Instead, provide concrete, measurable goals, such as "Reduce report errors to less than 5% per week."

What to focus on when writing the corrective action plan

The goal of discipline is to correct behavior, not just to punish. A well-structured corrective action plan gives the employee a clear path to success.

The best way to create one is by using the SMART framework to set goals.

  1. This means goals must be Specific, clearly stating what needs to change; for example, instead of "be more professional," use "you must refrain from using unprofessional language with clients."

  2. The goals must also be Measurable, defining how success will be tracked, such as having "zero unexcused absences for the next 60 days."

  3. It is also crucial that the goals are Achievable, meaning the expectation is challenging but realistic. Furthermore, each goal must be Relevant by directly relating to the misconduct or performance issue.

  4. Finally, the plan must be Time-bound, with a clear deadline for improvement and a schedule for check-ins, like reviewing progress in weekly one-on-one meetings for the next 30 days.

Here is a sample corrective action plan for an employee who has missed deadlines and submitted work with errors.

Goal: To ensure all assigned reports are submitted on time and meet the required quality standards for accuracy.

Specific Actions:

  1. The employee will create a project plan for each assigned report, outlining key milestones, and submit it to their manager for approval within 24 hours of receiving the assignment.
  2. The employee will use the provided "Report Quality Checklist" to review and self-edit each report for accuracy and completeness before submission.
  3. The employee will attend a one-hour training session on advanced features of our data analysis software, to be scheduled by the end of next week.

Measurement of Success:

  1. 100% of reports must be submitted by the agreed-upon deadline for the next 90 days.
  2. The error rate in submitted reports must be reduced by 90% compared to the previous quarter's average.


Timeline and Check-ins:

  • This plan will be in effect for 90 days, starting Monday, August 11, 2025.
  • Progress will be reviewed in a 15-minute check-in meeting every Friday at 10:00 AM.

What Are the Frequently Asked Questions About the Disciplinary Action Form?

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What is the purpose of an employee disciplinary action form?

Its purpose is to formally document a performance or conduct issue, communicate clear expectations for improvement, and protect the employer legally by ensuring a fair and consistent process for all disciplinary actions.

Does an employee have to sign a disciplinary form?

No. If the employee is unable or refuses to sign, the supervisor should note it on the form. The witness's signature becomes even more critical. With an e-signature platform, you can document that the form was delivered and viewed, even if it wasn't signed.

Can disciplinary actions be disputed?

Yes. Employees can use the "Employee Comments" section. Many companies also have a formal grievance process.

Ready to manage employee discipline with confidence and efficiency? Get started with Loio’s secure e-signature template to create, sign, and store your disciplinary action forms online.

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