About this template
A disciplinary action report is an essential human resources document used to officially record workplace policy violations, performance issues, or behavioral misconduct. Maintaining an accurate, objective record protects both the organization and the employee by establishing a clear timeline of events, expectations for improvement, and potential consequences if performance does not change.
This structured Google Form template helps supervisors, managers, and HR professionals document incidents consistently and fairly. It captures crucial details such as the date and time of the infraction, violation type, witness or supervisor statements, employee feedback, and the agreed-upon improvement timetable. By standardizing this process in Google Forms, HR teams can securely archive records, track repeat infractions, and maintain compliance with internal policies.
Whether you manage a small team or a large enterprise, Doc2Form allows you to instantly convert this template into a ready-to-use Google Form. Share it securely with management personnel to ensure all disciplinary actions are recorded with professionalism, clarity, and accountability.
Key features
- Standardize employee incident documentation across departments.
- Capture both supervisor and employee statements for fairness.
- Set clear improvement timetables and measurable performance goals.
- Securely store and organize all submissions in Google Drive and Sheets.
- Restrict access to sensitive HR records to authorized personnel only.
Use cases
Documenting repeated tardiness or unexcused absences.
Recording safety protocol violations in industrial or office environm…
Recording safety protocol violations in industrial or office environments.
Addressing unprofessional conduct or policy breaches in the workplace.
Establishing formal performance improvement plans (PIPs).
What this form collects
- Employee Full Name (Short answer)Enter the first and last name of the employee involved in the incident.
- Supervisor / Manager Full Name (Short answer)Enter the name of the supervisor or manager completing this report.
- Employee Email Address (Short answer)Provide the employee's work email address so a copy of the report can be shared.
- Incident Date (Date)Select the date when the incident or policy violation occurred.
- Incident Time (Short answer)Enter the approximate time the incident took place.
- Site and Shift (Short answer)Specify the work location and shift during which the incident occurred.
- Violation Type (Dropdown)Select the primary category that best describes the infraction.
- Supervisor / Employer Statement (Paragraph)Provide a detailed, objective description of the incident or performance issue observed.
- Action to be Taken (Dropdown)Specify the disciplinary action or corrective measures being implemented.
- Improvement Timetable (Short answer)Outline the specific timeframe expected for performance or behavioral improvement.
- Consequence if No Improvement (Paragraph)State clearly what further disciplinary actions will occur if standards are not met.
- Employee Statement Status (Multiple choice)Indicate whether the employee wishes to provide a written statement regarding this report.
- Employee Comments / Disagreement Reason (Paragraph)If the employee wishes to add context or state reasons for disagreement, enter it here.
- Acknowledgment and Signatures (Paragraph)Please paste a link to the signed document or type your full legal name to acknowledge receipt of this report.
FAQ
Who should complete a disciplinary action report?
Typically, the direct supervisor or manager initiates the report after an incident occurs or performance issues are identified, often in coordination with human resources.
Should the employee be given a chance to respond?
Yes. Best practices include incorporating an employee statement section so the team member can share their perspective, note any disagreements, or add context.
How does Doc2Form help set up this form?
Doc2Form instantly converts this template into a fully functional Google Form in your account, allowing you to customize questions and start collecting responses immediately.
Are disciplinary action reports kept confidential?
Yes. Because these reports contain sensitive employment information, responses should be restricted strictly to authorized HR personnel and relevant managers.
Can I export these reports to track trends?
Yes. Since the form connects directly to Google Sheets, you can easily review historical submissions to identify recurring issues or evaluate department-wide performance trends.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.