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Corrective Action Forms

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  4. Optimal Imaging

Corrective Action Template

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Corrective Action Form

Employee Name: ______________________________ Date: ____/____/______

Job Title: __________________ Supervisor: ____________________

Level of Corrective Action Required:

[__] Verbal Warning [__] Written Warning [__] Suspension [__] Termination

Facts Regarding the Incident:

Objective of Corrective Action:

Proposed Solution(s):

Action Taken:


________________________________ Date____________
Signature of Employee

________________________________ Date____________
Signature of Supervisor

________________________________ Date____________
Signature of HR Director

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