Employee Reprimand Form

Employee Reprimand Form

An employee reprimand form is used to document an employee’s workplace violation and the disciplinary measures that will be taken in response. It provides the employer with a written record of the incident and punishment, and informs the employee on what steps to take to correct the issue.

Last updated July 14th, 2025

An employee reprimand form is used to document an employee’s workplace violation and the disciplinary measures that will be taken in response. It provides the employer with a written record of the incident and punishment, and informs the employee on what steps to take to correct the issue.

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How to Reprimand an Employee

  1. Verbal warning. The need for an employee reprimand form may be avoided with an initial discussion with the employee to inform them of what’s expected of them.
  2. Repeated violation. If the violation reoccurs, the employer should gather the relevant details and any supporting documentation.
  3. Give form. The employer should fill out the form and give it to the employee during a private meeting to sign. The employer should keep a copy of the form in their records.
  4. Disciplinary action. The action outlined in the form (e.g., administrative leave, sent home, suspension) should be taken. A follow-up meeting can be held if desired.

Sample

PDF, MS Word, ODT

EMPLOYEE REPRIMAND

EMPLOYEE INFORMATION

Employee Name: [EMPLOYEE NAME] Work Location: [EMPLOYEE WORKPLACE]
Employee ID #: [EMPLOYER ID #] Issuing Supervisor: [SUPERVISOR NAME]

VIOLATION DESCRIPTION

Place of Violation: [VIOLATION LOCATION] Date of Violation: [MM/DD/YYYY]
Description of Violation: [VIOLATION DESCRIPTION]

DISCIPLINARY ACTION

Administrative leave with pay for [#] days
Sent home with pay
Suspension without pay for [#] days
Recommendation for termination
Other: [OTHER ACTION]
None

CORRECTIVE ACTIONS

Description of Corrective Actions to be Taken: [CORRECTIVE ACTIONS]

ACKNOWLEDGMENT

By signing below, I, [EMPLOYEE NAME], acknowledge that I have read and understood the contents of this Employee Reprimand Form.

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

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

Employee refused to sign this form and all attached documentation.