Employment Violation — Back to Basics Behavioral Health Services

Employee in violation

First Name

Last Name

Supervisors name addressing this violation

First Name

Last Name

Date of meeting addressing violation(s)

YYYY

Start time of meeting

Hour

Minute

Second

End time of meeting

Hour

Minute

Second

Name of people in attendance to this meeting

Reason for violation

Has this been addressed in the past?

Describe the events leading up to this meeting, and the meeting

Follow up session

Results/Solution

Name of person filling out this form

First Name

Last Name