Employee Misconduct – bookholyrides.com

General Information

Report Number

Date of Incident *

Time of Incident *

Hours

Minutes

Street Address of incident *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Employee Involved in Misconduct

Name of Employee *

Position/ Department *

Description of the Incident *

Was the misconduct directed at another employee or group? (If yes, name(s) of the affected employee(s):)

Severity of MisconductMinor (Could be resolved with a warning or counseling)Moderate (Requires further investigation or corrective action)Severe (Could result in termination or legal action)

Were there any injuries? ( If yes, specify the injuries:)

Was law enforcement involved? ( If yes, provide the officer’s name and report number:)

Witness Information

(List names of anyone who witnessed the incident or has relevant information.)

Immediate Actions Taken

(Describe what actions were taken immediately after the incident, such as speaking with the employee, removing them from a situation, or involving HR or management.)

Person Reporting the Incident

Name *

Phone *

Email Address *

Are you an employee or contractor? *EmployeeContractorOther

Affirmation of Truthfulness and Willingness to Testify

YesNo

Date of completion

Employee Misconduct Form

General Information