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Disciplinary Action Policy Form

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What Is It?

A Disciplinary Action Policy form is a document used by an organization or employer to outline the steps and procedures for handling employees who violate company policies or standards of conduct. This policy typically outlines the types of behavior that are considered unacceptable, the steps that will be taken in response to such behavior, and the consequences that may result, such as verbal or written warnings, suspension, or termination.

Typically, the Disciplinary Action Policy form should be reviewed and signed by the employee to acknowledge their understanding of the policy and their agreement to comply with its provisions.

When To Use?

A Disciplinary Action Policy form is used by an organization or employer when an employee violates company policies or standards of conduct. The form is used as part of a disciplinary process to correct the behavior and to communicate the consequences of such behavior.

The use of a Disciplinary Action Policy form is usually triggered by an infraction or violation of company policies or standards of conduct, such as poor performance, insubordination, theft, harassment, or violation of safety regulations. The form is used to document the infraction and the steps taken in response, including any warnings or disciplinary actions taken.

What To Include?

A Disciplinary Action Policy form should include the following information:

  1. Purpose: The purpose of the policy and the reasons for its implementation.
  2. Scope: The scope of the policy, including which employees are subject to it and under what circumstances.
  3. Types of Unacceptable Behavior: A clear and comprehensive list of the types of behavior that are considered unacceptable, such as poor performance, insubordination, theft, harassment, or violation of safety regulations.
  4. Disciplinary Process: The steps involved in the disciplinary process, including the procedures for investigation, documentation, and decision-making.
  5. Consequences: The range of consequences for unacceptable behavior, including verbal or written warnings, suspension, termination, or other appropriate actions.
  6. Appeal Process: The process for appealing disciplinary actions, including the procedures for filing a complaint and the steps involved in the appeal process.
  7. Employee Responsibility: A statement acknowledging the employee's responsibility to comply with the policy and to be aware of the consequences of their behavior.
  8. Review and Updates: A statement indicating that the policy is subject to review and updates and that employees will be notified of any changes.
EMPLOYEE INFORMATION
Employee’s Full Name
Position
Department
Supervisor/ Manager
Employee ID
Contact Phone Number:
Alternate Phone Number
Contact Address
INFRACTION INFORMATION
Date of Infraction
Description of Infraction
Witnesses
DISCIPLINARY ACTION TAKEN
Date of Disciplinary Action
Type of Disciplinary Action
Description of Disciplinary Action
Signatures of Employee and Manager
ACKNOWLEDGMENT OF DISCIPLINARY ACTION:
[Employee Signature]:
[Date]:

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Talent Resources & Development Director - Charoen Pokphand Group
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International Director - JB Hired
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HR Manager, Talent Sourcing & Acquisition - Suntory PepsiCo Beverage
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