Corrective Action/ Documentation Form

*A Corrective Action Form must be initiated by at least two house members. It is to be signed at a house meeting with all members in agreeance to stand as submitted. If anyone disagrees, it must be discussed and decided by a house vote.*

Intent of This Form

This form is used to document a concern raised by the house and addressed collectively through group conscience. Its purpose is to clearly outline agreed-upon expectations and consequences in a respectful, transparent, and supportive manner—holding members accountable while promoting growth and recovery, whether related to finances, recovery activities, or house responsibilities.

This form also serves to uplift one another and hold each other accountable in order to maintain an atmosphere of recovery.

Form to be completed at a house meeting with consequences agreed upon and approved by house group conscience.

The following section is to be filled by house members initiating the corrective action form.

House Member 1

Text field

House Member 2

Text field

House Member Receiving Corrective Action 

Client first name Client last name

Behavior / Issue in Question (as identified by house members):

Paragraph

Consequences of Non-Compliance (as agreed upon by the house):

Paragraph

The following section is to be filled by house member being placed on corrective action.

Member’s Plan of Action (in member’s own words):

(What steps will you take to remedy the issue?)

Paragraph

Member Name:
 Client first nameClient last name 

Member Signature:

Signature

Date:

Date