State of Wisconsin Department of Administration Division of Personnel Management DOA-15807-E (R9/2020) § 230.34 & § 111.80, Wis. Stats.	CASE NUMBER (If applicable): [Case Number]
EMPLOYEE INVESTIGATION REPORTS PRE-DISCIPLINARY MEETING
INSTRUCTIONS:	Document the content of the pre-disciplinary meeting and any exhibits provided.
SUBJECT OF INVESTIGATION (Last Name, First Name, M.I.)	JOB TITLE OR CLASSIFICATION	INCIDENT DATE
PRE-DISCIPLINARY
INTERVIEW DATE	TIME	EMPLOYEE REPRESENTATIVE PRESENT (Last Name, First Name)	MANAGEMENT REPRESENTATIVE NAMES (Last Name, First Name)
BEGIN THE MEETING BY REVIEWING THE FOLLOWING WITH THE EMPLOYEE: (IF NO REP PRESENT) Remind the subject the pre-disciplinary notice included the right to have a representative; since one is not present, you assume they would like to proceed without one and note it in the REPRESENTATIVE PRESENT box above. As appropriate state either: These proceeding will be recorded. You are entitled to receive a copy of the recording made during the meeting. OR These proceedings are not to be recorded. If it is found you have recorded this meeting, you will be in violation of work rule 11, which prohibits unauthorized recording. Ask if there are any questions about these guidelines before beginning. Inform the employee of management’s assessment of the essential facts which resulted in the finding a work rule violation occurred. Ask the employee if there any mitigating factors to consider? For potential criminal investigations – review the previously completed form DOA-15807-G – Investigations Involving Criminal Matters (Garrity / Oddsen Warning)
EMPLOYEE RESPONSE
CLOSE THE MEETING BY REVIEWING THE FOLLOWING WITH THE EMPLOYEE: State the meeting is concluded and retaliation against witnesses who participated, or believed to have participated, in this investigation is prohibited and subject to discipline. State the State of Wisconsin provides an Employee Assistance Program. Provide vendor web address, the phone number, or provide a brochure. Inform the employee they will be notified after the information is reviewed and a final decision is made.