Fillable Printable Employee Coaching Form - Kansas

Employee Coaching Form - Kansas

EMPLOYEE COACHING FORM

Employee Name: Title:

Department:

Supervisor Name/phone #:

DOCUMENTATION OF CONCERN(S), ISSUE(S) OR INCIDENT(S) INVOLVING:

⎯ Conduct or Behavior (Interpersonal Skills) ⎯ Department or University Rules

⎯ Safety or Work Environment ⎯ Attendance – Dependability

⎯ Customer Service ⎯ Other ________________________

Describe performance concern or issue (be specific, and in clude dates and examples):

Describe agree d upon solution(s) or course of action:

Note follow-up review plan date(s), etc.

Employee’s Signature: Date:

Supervisor’s Signatur e Date:

NOTE: Employee’s signature indicates that this information has been discussed with the employee. It also acknowledges receipt of a

copy of the coaching record. The employee may respond using the rev erse side of this form.

Distribution: (check all that apply): _____ Employee ____Sup ervisor ____Dept

Concern / Issue / Incident