Employee Counseling Form

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Employee Counseling Form

An employee counseling form records a meeting between a supervisor and an employee to address the employee’s behavior and set a plan for improved performance. The document is completed by the parties after discussing the matter privately to outline its causes and emphasize the remedies that the employee must make.

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Last updated July 28th, 2025

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An employee counseling form records a meeting between a supervisor and an employee to address the employee’s behavior and set a plan for improved performance. The document is completed by the parties after discussing the matter privately to outline its causes and emphasize the remedies that the employee must make.

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Benefits

  • Documents a course of action to correct the issue.
  • Provides a reference for future meetings.
  • Less confrontation than a warning or reprimand form.

Counseling an Employee

Counseling is a common method of resolving misconduct and can help avoid the need for disciplinary action. It allows the supervisor to voice concerns and for the employee to explain their side of the story.

While counseling is a confidential discussion between the employee and their supervisor, union workers may have a union representative attend.[1] If the employee refuses to sign, a witness may be required to indicate that they witnessed the employee receive the form and refuse to sign.

Sample

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EMPLOYEE COUNSELING FORM

Supervisor Name: [SUPERVISOR NAME]  Date: [MM/DD/YYYY]
EMPLOYEE INFORMATION

Employee Name: [EMPLOYEE NAME] Employee Department: [EMPLOYEE DEPARTMENT]
Employee Title: [EMPLOYEE TITLE]  Employee ID #: [EMPLOYEE ID #]

COUNSELING REASONS

This counseling form is being issued due to the following:

☐ Attendance
☐ Dress code
☐ Performance
☐ Behavior
☐ Teamwork
☐ Safety
☐ Violence
☐ Other: [REASON]

When did the incident happen?: [INCIDENT DATE/TIME]
Details of actions: [INCIDENT DETAILS]

EMPLOYEE COMMENTS

Enter any comments the employee has regarding the incident:
[EMPLOYEE COMMENTS]

CORRECTIVE ACTIONS

The following corrective actions must be taken by the employee:
[CORRECTIVE ACTIONS]

Immediate and sustained improvement is required. Failure to do so will result in appropriate disciplinary action up to and including termination.
By signing this form, the employee confirms they understand the information therein. The employee’s signature does not necessarily indicate agreement.

Employee Signature:                                                               Date: ______________
Print Name:[EMPLOYEE NAME]

Supervisor Signature:                                                               Date: ______________
Print Name:[SUPERVISOR NAME]

Witness Signature:                                                               Date: ______________
(If employee refused to sign)    Print Name:[WITNESS NAME]

Sources

  1. NLRB – Weingarten Rights