Employee write-up form (free, fill in your browser)
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Employee Write-Up Form
Incident details
Date(s): [Date(s) of the incident(s)]
Time and place: [Time and place]
[What happened, in facts]
Witnesses: [Witnesses]
Records attached: [Records attached]
Policy or expectation involved: [Policy or expectation involved]
Earlier steps on this issue: [Earlier steps on this issue]
Corrective action plan
[What needs to change]
Support offered: [Support offered]
Progress will be reviewed on or before [Review date].
If the issue is not corrected, or if it happens again, it may lead to [If it is not corrected, it may lead to].
This record is not a contract and does not change the terms of employment.
Employee comments
The employee may write comments below or attach a separate written response, which will be kept with this record.
________________________________________________
________________________________________________
________________________________________________
________________________________________________
Acknowledgement
Signing below confirms that the employee received this record and that it was discussed with them. It does not mean the employee agrees with it.
______________________ Date: __________
Employee signature ([Employee name])
______________________ Date: __________
Supervisor signature ([Supervisor completing this form])
If the employee declines to sign: witness name, signature and date: ______________________
For names with non-Latin characters, use .docx.
About this form
One form for every step of discipline: coaching note, verbal or written warning, final warning or suspension. It records the facts, the rule involved, the plan and the employee's side, with filled-in examples.
A write-up form is the record behind a disciplinary step. The same form works as a disciplinary action form, a corrective action form or an employee counseling form: what changes is the type of action you tick, not the fields a good record needs.
Every field in the form is there for a reason: the dates and facts show what happened, the policy line shows which rule was involved, the plan and review date show what was asked, and the employee comments show they had a chance to respond. Fill it in, check the preview and download it. Nothing you type leaves your browser.
How to use this template
- Fill in the form before the meeting, while the facts are fresh. Pull time sheets, emails or other records and list them under records attached.
- Tick the type of action that matches the step you are taking. Use the same step for the same issue across employees.
- Write the plan so it can be checked: what, by when, and how you will know. Put the review date in your calendar.
- Meet in private, go through the form and give the employee time to add comments.
- Ask for a signature that confirms receipt, not agreement. If they decline, note it and have a witness sign.
- Give the employee a copy and keep the signed original in the personnel file.
Example wording
Examples of the level of detail that makes a document clear. Replace them with your own facts.
- Attendance: On June 3, June 10 and June 17 you clocked in at 9:38, 9:52 and 9:41 a.m. for a 9:00 a.m. shift and did not call ahead. On June 10 the store opened 20 minutes late. Plan: arrive by 9:00 a.m. on scheduled days and call the shift lead before 8:30 a.m. if you will be late. Review: July 15.
- Conduct: On May 6, during the 2:00 p.m. team meeting, you raised your voice at a colleague and used profanity after being asked to wait your turn to speak. Two team members were present. Plan: raise disagreements calmly in the meeting or privately with your supervisor afterwards. Review: June 6.
- Performance: Three of the last five client reports (sent April 2, April 9 and April 16) went out with pricing errors that the client flagged. Plan: run the pricing checklist on every report and have it reviewed by a second person before sending. Support: checklist walkthrough on April 20. Review: May 20.
- Safety: On August 12 at about 11:15 a.m. you operated the floor scrubber in aisle 4 without the required safety glasses, after a reminder at the August 1 safety briefing. Plan: wear the listed protective equipment every time you operate the machine. Review: September 12.
Questions people ask
What is a write-up at work?
A write-up is a written record that an employee was told about a problem with attendance, performance or conduct, what needs to change and by when. It is usually one step in a progressive discipline process that runs from a coaching conversation or verbal warning, to a written warning, to a final written warning.
Is a disciplinary action form the same as a write-up form?
In practice, yes. Disciplinary action form, corrective action form, employee counseling form and write-up form are different names for the same record: who, what happened, the rule involved, the plan and the signatures. This form covers all of them; you choose the type of action at the top.
What should be included in an employee write-up?
The date, the employee and supervisor, the type of action and issue, the facts of what happened with dates, any witnesses or records, the policy or expectation involved, earlier steps on the same issue, what needs to change, a review date, the possible consequence, space for the employee's comments and signatures.
Can an employee refuse to sign a write-up?
An employee can decline to sign. The signature line is there to confirm receipt, not agreement, and the form says so. If they decline, write 'employee declined to sign' with the date and ask a witness who was present to sign. The record still documents the conversation.
Is a verbal warning considered disciplinary action?
Many employers treat a verbal warning as the first formal step of discipline, which is why it is usually written down afterwards on a form like this one. Your own policy decides which steps exist and in what order; apply them the same way to everyone.
How long should a write-up stay in the personnel file?
Your own policy decides how long a warning counts toward the next step. Separately, the EEOC's recordkeeping page says employers keep all personnel or employment records for one year, and that the records of an involuntarily terminated employee are kept for one year from the date of termination. State rules can be longer.
The full process
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Checked Sep 24, 2026 · How we verify every rule · Report an error