U-C 3 CEA Employee Counseling Form

  • Supervisor's information

  • Block 1 - Employee & Jobsite Data

  • :
  • Block 2 - Type of Behavior

  • Block 3 - Description of Circumstances

    Describe the employee's behavior and circumstances under which the behavior was observed. Included dates, times, locations, witnesses, etc.
  • Block 4 - Desired Future

    Describe the behavior desired for the future, if appropriate.
  • Block 5 - Counselor's Recommendations & Follow-up

    Remember: Recognize / Reward Exceptional Behavior. Redirect and retrain whenever possible, if behavior is inappropriate. Suspend only as a last resort. Follow-up is REQUIRED where the demonstrated behavior is inappropriate. Typically follow-up is to be scheduled for 30, 60 & 90 days after the incident behavior does not repeat. Follow-up is not needed for call-offs/exceptional performance.