PERFORMANCE IMPROVEMENT PLAN MEMO

EMPLOYEE NAME	ROLE / TITLE	EMPLOYEE ID
SUPERVISOR	DEPARTMENT	DATE

AREAS OF CONCERN

In what areas have expectations not been met?

Previously addressed issues

Provide details of any previously addressed issues, the context, and the outcome of discussions or training.

IMPROVEMENT GOALS and activities

Provide specific goals as they relate to areas of concern to be addressed and improved upon and activities designed to achieve the set goals.

expected results

Provide details of desired outcomes and measurements of success where applicable.

TIMELINE FOR IMPROVEMENT, CONSEQUENcES, AND EXPECTATIONS

Provide a schedule for progress assessment and a summary of any stipulations placed upon the performance improvement plan, consequences of insufficient effort, and any legal concerns, such as confidentiality as related to this document.

SIGNATURES

EMPLOYEE NAME	EMPLOYEE SIGNATURE	DATE

SUPERVISOR NAME	SUPERVISOR SIGNATURE	DATE

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