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Record of Disciplinary Meeting

Date of Writing ……/……/…….

This is a record of a Disciplinary Meeting between:
Employer or Designated Person………………………………………………………………………….
and
Employee…………………………………………………………………………………………………………….

This Disciplinary Meeting happened on ……/……/…… (If different from the Date of Writing).
This Record will be placed in the Employee’s record but will be disregarded for disciplinary purposes after a period of ………… months, provided Employee conduct improves/performance reaches a satisfactory level*. A copy will also be provided to the Employee for their own records.
a) The nature of the unsatisfactory conduct or performance was:

b) The conduct or performance improvement expected is:

c) The timescale within which the improvement is required is:

d) The likely consequence of further misconduct or insufficient improvement is:

EMPLOYEE DECLARATION**
I certify that the information above is an accurate record of the Disciplinary meeting and the information is true and accurate.
I will endeavour to improve my conduct/performance to the agreed standard.
I acknowledge that failure to improve my conduct/performance will result in further disciplinary action/dismissal.
EMPLOYER DECLARATION**
I certify that the information above is an accurate record of the Disciplinary meeting and the information is true and accurate.
I will respect the timescale and improvement in conduct/performance expected of my Employee outlined above.
I will carry out any disciplinary action relating to further misconduct/insufficient performance as agreed in this record.

Employee Signature: ………………………………

Employer Signature: ………………………………………

* Delete if inappropriate
** The wording should be amended as appropriate

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