This template provides a structured, legal, and consistent format for formally documenting an incident of employee insubordination, outlining the violation, the specific consequences, and the clear expected improvements required to resolve the disciplinary issue.
- Employee and incident information: Fields for employee name, job title, ID, manager name, department, and date
- Incident details and classification: Sections to specify the employee responsibilities related to the incident, the type of warning (first, second, or final), and a detailed description of incident
- Policy and consequence: Fields to reference the type of policy or rule violation and an outline of the specific consequences (disciplinary action) to be taken
- Expected improvement plan: A dedicated section to list 3 specific expected improvements (behavior/goals) with corresponding due dates
- Formal acknowledgement: Signature blocks and dates for the employee, manager, and HR to formally acknowledge the issuance and receipt of the warning


