Date:

To:

From:

Cc:

Re: Written Warning-{Poor Performance or Attendance}

On {Insert Date} you were issued a verbal warning regarding {Insert description of performance/attendance issue or cite violation of policy and/or procedure}.

On {Insert date of subsequent violation} you again {Insert description of performance/attendance issue or cite violation of policy and/or procedure}

{Insert Description of how the issue impacts the employees work and/or overall functioning of the department}. {Explain corrective action required}. Therefore, this memo serves as a written reprimand and notification that if these behaviors continue or an additional violation of EVMS policy occurs further disciplinary action will be taken up to and including termination.

The above has been discussed with me by my supervisor. I understand the contents and acknowledge and understand that if the above issue continues further disciplinary action may be taken up to and including termination. Signing below indicates only that the content of this document have been reviewed with you. It does not indicate agreement with the content. You may provide a written rebuttal to this document that will be included in your personnel file.

___________________________________	______________________

{Employee Name}	Date