Cartage Australia Pty Ltd
ABN 60 108 355 344
PO Box 879 Cranbourne Vic 3977
Tel: (03) 5996 1019 Fax: (03) 5996 6570

Disciplinary Interview Form

STRICTLY PRIVATE AND CONFIDENTIAL

This form is used to record details of allegations & the employee’s response to the allegations.
If after all the facts have been considered, and should a decision be made that disciplinary action (warning) should be taken, the recommendation must be made to the HR Manager, not to the employee.
Outcomes requiring HR approval require two (2) Management Representatives to be present during the interview.
Ask Employee if he/she wishes to have a Support Person present.

Contact the HR Manager for further guidance and assistance.

Management Representatives

Management Representative 1 *

Title *

Other Management Representative 1 *

Manager Email *

Manager Type

Manager Disciplinary Action Authority

Management Representative 2 *

Title *

Other Management Representative 2 *

Second Manager Email *

Second Manager Type

Second Manager Disciplinary Action Authority

Interview Details

Interview Date and Time *

Interview Location *max. 255 characters.

Employee

Lookup

If your Employee Code is not yet in the system please manually add your details below.

First Name *

Last Name *

Email Address *For posting of your record of transaction.

Job Title *

Support Person Present? *

YesNo

Support Person Name *

Type of Disciplinary Interview *

Speed Management Procedure

Fatigue Management Policy

Allegations put to the employee *Reference (if any) to previous counselling/ interviews/disciplinary warnings relating to similar matter(s).

Employee’s response to the above allegations *

Interview Outcome/Recommendation

Interview Outcome or HR Recommendation *

Refer to HR for ReviewNo Action (allegation not substantiated)CounsellingFirst Written WarningFinal Written Warning (requires HR Approval)First and Final Written Warning (requires HR Approval)Termination of Employment (requires HR Approval)

HR Approval is Required for this proposed Outcome.

Manager in attendance has authorised the outcome.

Employee Signature