Safety Breach Warning Letter

This template may be used as a practical guide when preparing formal disciplinary notice for employees who engage in misconduct, insubordination, negligence, excessive tardiness/absenteeism or any other behavior that may be harmful to the operation of the University or to the rights and safety of University staff, students, patients or visitors.. Sample Letters: Please select item/s as appropriate Unprofessional Conduct Insubordination Verbal Altercation Abusive Language Refusal to Follow Supervisor s Instructions Excessive and/or patterned Absenteeism/Tardiness Excessive Absenteeism Required to Provide Physician Documentation for Use of All Sick Time Excessive Absenteeism, Required to Provide Clearance to Return to Work Final Warnings HIPAA Violation Unprofessional Conduct Insubordination, Unprofessional Conduct, Inappropriate Language Failure to Notify Supervisor Prior to Leaving Office/Unit, Insubordination, Failure to Follow Procedure When Requesting Time Off Return from Medical Leave, Worker s Compensation, and Clarification of Employment Status Unauthorized Disclosure of University Information, Insubordination Letters should state behavioral deficiencies and site specific occurrences.. Sincerely, Supervisor Title Department CC: Human Resources Personnel File Final Warning HIPAA Violation To: Employee name Job Title Department From: Supervisor name Job Title Date: Subject: Final Warning HIPAA Violation This letter is to serve as a final warning letter: Recently, a situation was uncovered in which you displayed a serious lack of judgment and unprofessional behavior which is against University Policy and the Health Insurance Portability and Accountability Act (HIPAA).. Employee name Date CC: Human Resources Personnel File Final Warning Unprofessional Conduct To: Employee name Job Title Department From: Supervisor name Job Title Date: Subject: Final Warning Unprofessional Conduct This letter serves as a final warn