Final Corrective Action Example

Page 1

Corrective Action Form

Updated

The purpose of this Corrective Action is to bring to your attention new or ongoing deficiencies in your conduct and/or performance, and to provide you with the opportunity to make the necessary improvement. In the space provided, you are welcome to provide any feedback you may have about this Corrective Action.

Reason for Corrective Action: Please describe the policy violation or unsatisfactory performance or behavior that must be corrected.

Prior Corrective Action(s): Please list any relevant preceding verbal or documented corrective actions.

Required Corrective Action: Please describe the immediate and sustained corrective action that must be demonstrated by the associate.

Corrective Action Form Page 1 of 2
March 2022
Location
Department
Date Administered
Associate Name
/
Associate Position
Type of Corrective
Issuing Leader
Action
Initial Corrective Action
Final Corrective Action

Associate Comments

Signatures

This Corrective Action has been discussed with me by my supervisor. I acknowledge and understand the corrective action that is expected of me. I also acknowledge and understand the potential consequences of noncompliance, which may include further disciplinary action up to and including termination of employment.

Associate:

Date:

Leader:

Date:

Corrective Action Form Page 2 of 2

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