Corrective Action Form
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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:
Comments:
_______________________ Date_____
Signature of Employee
_______________________ Date_____
Signature of Supervisor
_______________________ Date_____
Signature of HR Director
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