1. What specific areas, with measurable and tangible goals, would you like to see this employee improve?
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2. Reasonable Improvement Time Frame:
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Next occurance during time frame:___________________________________________
Extension or maintenance period:____________________________________________
Scheduled follow-up /review meeting:________________________________________

3. Consequences if performance expectations are not met: discipline steps (e.g. verbal
or written warning)
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Employee Acknowledgement -- Improvement Plan Input:
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I acknowledge the PIP--Employee Name/Signature Date

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Supervisor Name/Signature Date