Employee Performance Reporting Form

I'm concerned about (Employee Name):
 
   
Supervisor's Name:  
   
Supervisor's Email  
 
   
Reason for Concern:  
Attendance  
Team/Coworker Issues  
Stress  
Isn't Completing Tasks  
Level of work seems too difficult  
Attitude  
Inappropriate Behavior  
Other  
If you selected other, please describe:  
 
     
Add general comments to explain what is going on:  
 
     
What actions have you taken, or would like HR to take?  
I have discussed this issue with the employee
I have discussed this with the employee previously and want to set up a performance improvement plan
I would like to talk this through with HR.
No action necessary at this time*.

*Depending on the issue, it may not be possible for HR to take no action, especially if the situation is related to sexual or general harassment, or discrimination.