"Employee Conference Form"

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EMPLOYEE CONFERENCE FORM
This form documents the following:
Coaching Session
Oral Reminder
Written Reminder
Employee Name:
Title:
Department:
Supervisor Name/phone #:
DOCUMENTATION OF CONCERN(S), ISSUE(S) OR INCIDENT(S) INVOLVING:
⎯ Conduct or Behavior (Interpersonal Skills)
⎯ Department or University Rules
⎯ Safety or Work Environment
⎯ Attendance – Dependability
⎯ Customer Service
⎯ Other ________________________
Describe performance concern or issue (be specific, and include dates and examples):
Describe agreed upon solution(s) or course of action:
Failure to resolve the issues could result in further disciplinary action up to and including a decision-making leave,
demotion, and/or dismissal.
Note follow-up review plan date(s), etc.
Employee’s Signature:
Date:
Supervisor’s Signature
Date:
NOTE: Employee’s signature indicates that this information has been discussed with the employee. It also acknowledges receipt of a
copy of the coaching record. The employee may respond using the reverse side of this form.
Distribution: (check all that apply):
_____ Employee ____Supervisor
____Dept
Reset Form Fields
EMPLOYEE CONFERENCE FORM
This form documents the following:
Coaching Session
Oral Reminder
Written Reminder
Employee Name:
Title:
Department:
Supervisor Name/phone #:
DOCUMENTATION OF CONCERN(S), ISSUE(S) OR INCIDENT(S) INVOLVING:
⎯ Conduct or Behavior (Interpersonal Skills)
⎯ Department or University Rules
⎯ Safety or Work Environment
⎯ Attendance – Dependability
⎯ Customer Service
⎯ Other ________________________
Describe performance concern or issue (be specific, and include dates and examples):
Describe agreed upon solution(s) or course of action:
Failure to resolve the issues could result in further disciplinary action up to and including a decision-making leave,
demotion, and/or dismissal.
Note follow-up review plan date(s), etc.
Employee’s Signature:
Date:
Supervisor’s Signature
Date:
NOTE: Employee’s signature indicates that this information has been discussed with the employee. It also acknowledges receipt of a
copy of the coaching record. The employee may respond using the reverse side of this form.
Distribution: (check all that apply):
_____ Employee ____Supervisor
____Dept