Disciplinary Report Form

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Disciplinary Report Form Employee Name: Job Title: Department: Supervisor: Date/Time of Occurrence: Location: Type of Offense: Absenteeism Misuse of property/equipment Lying or cheating Poor work quality Poor hygiene Using inappropriate language Bringing weapon onsite Sleeping on the job Tardiness Theft or fraud Falsifying documents Poor work quantity Posting items without permission Rudeness Bringing illegal drugs/alcohol onsite Disregarding dress code Leaving work without permission Leaking confidential information Unsafe behavior/horseplay Smoking in undesignated area Fighting or creating conflict Abusiveness Failing to follow instructions Other Facts of Incident: (Attach additional page if necessary) Past Disciplinary Action: Date Type Was written report prepared Yes No Details: Past Disciplinary Action: Date Type Was written report prepared Yes No Details: Conseq


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