Employee Counseling Form

First and Last or initials Example: John Anderson or JA
Full Date: Jan 1, 2025
Name or initials
This is for my employee review or I was late to work on 11/21/2025.
Example: The truck was damaged on the bumper. The wreck is going to cost money. I was late to the appointment. Dispatch had to adjust the schedule with short notice.
Example: The wreck was deemed not my fault. I learned that my actions were responsible for this accident. I prevented the truck fire by following the policies.
Example: I should have submitted my paperwork on time, I could have gotten out of the truck and looked, or gloves would have protected my hands from the cut.