A Disciplinary Action Form is a formal document detailing an employee’s bad performance or misconduct, the company’s response to it, and the corrective actions to be taken in the future.
Issuing this form signifies a notable development in the overall employee disciplining process. An EDA form is only filed out when an employee fails to meet the company’s expectations. Most companies tend to specify these expectations in their employee handbook, internal SOPs, or the employment contract itself.
Failing short of these expectations by ignoring or breaking company rules can lead to a change in employment status. For example, the disciplinary Committee may, in light of evidence contained in the EDA form, decide to demote, reassign, suspend, or even terminate an underperforming employee.
These forms can be used for both performance management & legal purposes. From a legal perspective, it is important to keep a clear & verifiable record of these incidents so you don’t have to deal with a wrongful termination suit down the road. That way, if any legal issues come up, you can prove that you did your due diligence before letting them go. From a managerial point of view, disciplinary action forms serve as internal records of any official decisions made by HR, helping you manage and monitor employee performance.
We at WordLayouts have designed an Employee Disciplinary Action Form template to standardize the process of documenting disciplinary actions. This form will help implement consistent standards across your organization, ensuring that all employees are treated fairly!
Key Sections of Our Form
Although the majority of these forms contain identical features, you can always customize our disciplinary action form to fit the needs & context of your company:
Our Form records:
- Employee details
- Type of Violation
- Previous Warnings (if any)
- Details of the incident when the employee violated company or workplace rules
- Statements made by employees and supervisor as well as witnesses (if any)
- Disciplinary action taken (say, demotion, salary cuts, or termination of the contract altogether)
- Corrective actions specified by the company or HR, and their expected outcomes
- Possible consequences in case of failure to comply
- Any evidential material attached to back up the information or claims made in the form
- Dated signature of the manager or supervisor
- Dated signature of the employee denoting receipt of the form
- Employee’s rebuttal to the contents of the form
Now, let’s explore each section of our Disciplinary Action Form in more detail…
Employee Information
It covers the basic details about the employee, such as their name, position, and Employee ID, while also specifying the broader work hierarchy they are a part of (say, which department they work for, or who their supervisor is).
Violation Type
From minor infractions to major code of conduct violations, there are many types of violations for which employees may face disciplinary action.
Based on our research, we included the following:
- Work performance
- Substance abuse
- Asset misuse
- Attendance
- Tardiness
- Inappropriate dress
- Violence
- Safety violation
- Tampering with records
- Insubordination
- Inappropriate conduct
If you want, you can easily delete, add to, or replace our default categories using an editable version of the file.
Previous Warning
The rationale for this section is to identify if a previous warning has been issued to the same employee for the same or a similar reason. If so, you will need to specify further whether this is the first, second, or third time a warning is being issued.
In a court of law, this section can be used to show that the employee was given a fair warning or chance before strict action was taken against them.

Incident Details
In the next subsection, you unravel the mystery of what happened.
Use this section to provide a detailed account of the incident; this ensures that all parties have a clear understanding of which specific issue or incident is being referred to. Some questions will be quite simple and straightforward (such as the date and location of the incident), while others will require a little more thought and effort.
Relay the incident with as much detail as possible. The more specific you are, the easier it will be to review the form. For example, if a written company manual was violated, include a reference to the rule that was violated.
Our template also includes a dedicated space where you can add the statements of an employee or supervisor. These statements may be referred to by the disciplinary committees as a reference of what happened & why. They may also act as evidence if the incident escalates and requires legal action in the future.

We also add separate sections for you to collect and include statements from witnesses. Use discretion when gathering information to protect the privacy of the witnesses.

Disciplinary Action Taken
From a verbal or written warning all the way to suspension and termination, there are a number of different disciplinary actions taken by companies when employees violate company policies or procedures. The key is knowing which disciplinary process to apply to each type of behavior. When in doubt, ask an HR manager or specialist for advice.
In this section, you specify what action is being taken against the employee. This allows you to escalate the situation and alert the human resources team to ensure that proper procedures are followed.
Our form allows you to select from one of these options:
- Demotion
- Suspension with pay (dated)
- Suspensions without pay (dated)
- Termination (including the date on which termination is effective)
If you are taking any disciplinary action other than those specified above, you can simply select the ‘Other’ option. Now, use the blank to specify the action being taken. This could be a one-time salary cut or a removal of certain privileges or responsibilities.
Remember, each disciplinary decision should be taken with care to avoid violating the Fair Labor Standards Act (FLSA)s. Moreover, if an employee is on a leave of absence under the Family and Medical Leave Act (FMLA), they have certain protections against termination and reassignment.
For HR professionals, we provide an overview of laws to help you avoid the risk of legal action down the line!
Corrective Actions
Here, write a corrective action plan for the employee to follow. This plan should outline specific actions that must be taken to prevent a similar episode from occurring in the future. For example, suppose an employee used a condescending tone with a client or customer. In that case, they may be reminded to avoid using rude language in the future or enroll in a course on social etiquette and mannerisms.
When identifying corrective actions, it’s important to specify a deadline as to when you expect these corrective actions or changes to be in place.
In the second part, identify the expected outcomes of these corrective actions. In this example, expected outcomes may be increased customer service rankings or higher sales.
Below, we have added a checklist of possible disciplinary consequences that may be taken if the employee fails to meet company expectations. It’s crucial that the employee understands the gravity of the situation and the potential impact on their employment status. This helps manage expectations and highlights the importance of following company standards.
Consequences may be in the form of:
- Demotion (Moved to a lower rank or position)
- Suspension (Temporary removal with or without pay)
- Reassignment (Moved to another team, department, or project)
- Loss of company privileges
- Termination (Ending the employment contract as a last resort)
- Performance Improvement Plans (Click here to learn more about PIPs)

Pro Tip for Managers
While some violations may be serious enough that they call for immediate termination, in most cases, it’s standard practice to give employees a fair warning or a last chance to step up their game. In situations where there is still room for hope, the best option is a performance improvement plan, in which the employee is given a firm timeframe and milestones for addressing their behavior.
If the employee doesn’t improve, clearly state the potential consequences, including further disciplinary actions up to and including termination.
Evidentiary Material
Now, ask yourself what solid proof do you have that someone underperformed or behaved inappropriately?
In this section, you get to list down specific evidence to back up the information contained in the previous sections. From performance & attendance records to WhatsApp screenshots, evidentiary materials can vary depending on the nature of the incident and the policies of your company.
Here are some different types of evidentiary materials you can attach to the form:
- Supervisor or investigator notes
- Records of any digital communication relevant to the case
- Specific company policies being violated
- Employee’s attendance or leave records
- CCTV footage for time-stamped recordings of incidents.
- Photo evidence of damage, injuries, or locations relevant to the event.
- Computer activity logs (websites visited, time spent online, etc.)

Do Employees Have to Acknowledge the Contents of the Form?
There is no legal obligation upon employees to agree with the contents of the form. In an ideal scenario, the employee will sign the disciplinary action form, agreeing to take appropriate follow-up actions. But in some cases, they may dispute the written version of events, or disagree that they violated company policy at all.
That’s precisely why we add two different acknowledgement sections to our form. Signing the first section (Acknowledgement) means the employee confirms that they have received the form and fully understands the corrective actions laid out for them. They also acknowledge possible repercussions should they fail to improve their behaviour or performance.

Refusal Acknowledgement
If employees disagree with the contents of the form, they shall complete the second section (Refusal Acknowledgment). While a signature confirms that they received or read the Form, it doesn’t mean complete agreement with the information it contains.
Consider allowing the employee to attach a rebuttal of their own, or to acknowledge that they received a copy of the document without agreeing to its veracity. We have also added blank space for employees to record & share their main points of disagreement. For a more detailed response, employees may be asked to prepare a dated and signed rebuttal and attach it to the disciplinary action form.

Overview of Laws for HR Managers
Here’s a broad overview of some of the key federal laws in the US you might want to study from an HR point of view:
Title VII of the Civil Rights Act (1964)
As an HR manager, Title VII requires all employees to be treated equally regardless of race, color, religion, sex, or nationality. Discrimination in hiring, firing, promotions, and compensation is prohibited. Employees are not to be harassed or retaliated against for asserting their rights under the law. HR must also create policies and programs that promote diversity and inclusion, ensuring that coming to work is a positive experience for everyone. (Source)
Americans with Disabilities Act (ADA) (1990)
Ensure that people with disabilities are not discriminated against in any aspect of employment, including hiring, promotions, and job duties. Reasonable accommodations should be made for them to help them do their jobs. Confidentiality about an employee’s disability status is essential. (Source)
Age Discrimination in Employment Act (ADEA) (1967)
This law protects workers aged 40 and above from ageist practices in hiring, promotions, wages, or termination. Biased comments or decisions must be actively discouraged. As an HR manager, it’s vital to maintain policies and training programs that reinforce a non-discriminatory, inclusive environment for employees of all ages. (Source)
Fair Labor Standards Act (FLSA)
Comply with FLSA regulations on minimum wage, overtime, and record-keeping requirements. Classify your employees as either exempt or non-exempt and indicate whether they receive appropriate compensation for hours worked over 40 per week. HR must also ensure proper documentation of work hours for non-exempt employees. (Source)
National Labor Relations Act (NLRA)
Protects employees’ rights to organize, join unions, and participate in collective bargaining. Avoid interfering with, restraining, or coercing employees regarding union activities. Employees have the right to discuss workplace conditions and wages, and HR should ensure management is trained on how to handle these discussions in a legally compliant manner. The law also protects workers from retaliation when they engage in concerted activities. (Source)
Pregnancy Discrimination Act (PDA)
HR managers must ensure that pregnant employees or those with related medical conditions are treated the same as other employees with temporary medical conditions. This includes accommodations for pregnant workers, such as modified tasks or more frequent breaks. HR must ensure that maternity leave policies and job protections align with legal requirements. Women not to face job loss or reduction in pay due to pregnancy. (Source)
Equal Pay Act
Requires that men and women be paid equally for performing the same job with similar skill, effort, and responsibility. Managers to ensure that compensation practices are free of gender bias. HR should also promote transparency in salary structures and address any employee concerns related to pay equity. (Source)
Family and Medical Leave Act (FMLA)
Grant unpaid, job-protected leave for certain family and medical reasons. Ensure employees are informed of their rights to take up to 12 weeks of leave for childbirth, adoption, or serious health conditions. HR must also maintain employee health benefits during this leave and guarantee job reinstatement upon return. (Source)
Health Insurance Portability and Accountability Act (HIPAA)
Protect the confidentiality of employees’ medical information. HR must ensure that health data is stored securely, and only authorized personnel have access to it. When handling medical leaves or accommodations, only disclose information on a need-to-know basis. Ensure proper training on privacy standards to prevent violations and maintain trust with employees. (Source)
State Privacy Laws (e.g., California Consumer Privacy Act – CCPA)
HR managers must be aware of state-specific privacy laws which provide employees with rights over their data, including the right to access, delete, and opt-out of the sale of their data. HR should establish protocols to handle data requests from employees and ensure compliance with these privacy regulations. This includes securing employee data, implementing transparency in how personal information is used, and providing clear privacy notices. (Source)
Non-Disclosure Agreements (NDA) and Confidentiality
Employees are bound by NDAs or confidentiality agreements where they are privy to sensitive company information or business secrets. HR should incorporate clear, enforceable confidentiality clauses into employment contracts. Communicate the implications of these agreements during onboarding and ensure that everyone understands their responsibilities regarding confidential information.
At-Will Employment
At-will employment means that both parties can terminate the employment at any time for any lawful reason. As HR, it’s your job to make sure that employees understand this concept during their onboarding. But you must also ensure that the termination is fair and based on lawful grounds, as at-will status does not protect against discrimination, retaliation, or breach of contract claims. Document any performance or disciplinary issues carefully to avoid a heavy lawsuit down the road.
Wrap Up
Knowing how to properly write up an employee incident helps you protect your business in the event of legal actions in the future. By using our pre-made form with fillable sections, you can save yourself hours in research, design, and formatting work!
But before you write someone up, it’s best to communicate with the employee verbally and informally before taking any strict formal action against them. Even then, disciplinary action isn’t meant to be punitive, at least not always. While some employees may fail or simply refuse to mend their ways and be forced to leave the company, others will see it as a wake-up call, using it as an opportunity to grow & improve.









