Employee Incident Report Form Template
Employee Incident Report
Date
Employee Manager
Name Name
Title/position Title/position
Incident
Date
Time
Location
Description of incident
Employee explanation
Witnesses
Action to be taken
❏ Verbal warning ❏ Probation ❏ Dismissal
❏ Written warning ❏ Suspension ❏ Other
Explain
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Employee Manager
Date Date
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