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    Developmental Counseling Form: The Leader's Facts and Observations Prior To The Counseling.)

    Uploaded by

    Dylan Christopherson
    This document is a developmental counseling form used to assist leaders in conducting and recording counseling data for subordinates. It contains administrative data about the counseling such as names, ranks, and dates. The form also includes sections to document the background/purpose of counseling, a summary of the key discussion points, a plan of action, and an assessment of whether the plan achieved the desired results. Leaders and individuals counseled both provide input and signatures to complete the form.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Developmental Counseling Form: The Leader's Facts and Observations Prior To The Counseling.)

    Uploaded by

    Dylan Christopherson
    54 views2 pages
    This document is a developmental counseling form used to assist leaders in conducting and recording counseling data for subordinates. It contains administrative data about the counseling such as names, ranks, and dates. The form also includes sections to document the background/purpose of counseling, a summary of the key discussion points, a plan of action, and an assessment of whether the plan achieved the desired results. Leaders and individuals counseled both provide input and signatures to complete the form.

    Original Description:

    Developmental Counseling Form

    Original Title

    DA Form 4856

    Copyright

    © © All Rights Reserved

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    This document is a developmental counseling form used to assist leaders in conducting and recording counseling data for subordinates. It contains administrative data about the counseling such as names, ranks, and dates. The form also includes sections to document the background/purpose of counseling, a summary of the key discussion points, a plan of action, and an assessment of whether the plan achieved the desired results. Leaders and individuals counseled both provide input and signatures to complete the form.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    54 views2 pages

    Developmental Counseling Form: The Leader's Facts and Observations Prior To The Counseling.)

    Uploaded by

    Dylan Christopherson
    This document is a developmental counseling form used to assist leaders in conducting and recording counseling data for subordinates. It contains administrative data about the counseling such as names, ranks, and dates. The form also includes sections to document the background/purpose of counseling, a summary of the key discussion points, a plan of action, and an assessment of whether the plan achieved the desired results. Leaders and individuals counseled both provide input and signatures to complete the form.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    DEVELOPMENTAL COUNSELING FORM

    For use of this form, see FM 6-22; the proponent agency is TRADOC.
    DATA REQUIRED BY THE PRIVACY ACT OF 1974
    AUTHORITY:
    PRINCIPAL PURPOSE:
    ROUTINE USES:

    5 USC 301, Departmental Regulations; 10 USC 3013, Secretary of the Army.


    To assist leaders in conducting and recording counseling data pertaining to subordinates.
    The DoD Blanket Routine Uses set forth at the beginning of the Army's compilation of systems or records notices also
    apply to this system.

    DISCLOSURE:

    Disclosure is voluntary.

    Name (Last, First, MI)


    Organization

    PART I - ADMINISTRATIVE DATA


    Rank/Grade

    Date of Counseling

    Name and Title of Counselor


    PART II - BACKGROUND INFORMATION

    Purpose of Counseling: (Leader states the reason for the counseling, e.g. Performance/Professional or Event-Oriented counseling, and includes
    the leader's facts and observations prior to the counseling.)

    PART III - SUMMARY OF COUNSELING


    Complete this section during or immediately subsequent to counseling.
    Key Points of Discussion:

    OTHER INSTRUCTIONS
    This form will be destroyed upon: reassignment (other than rehabilitative transfers) , separation at ETS, or upon retirement. For separation
    requirements and notification of loss of benefits/consequences see local directives and AR 635-200.

    DA FORM 4856, AUG 2010

    PREVIOUS EDITIONS ARE OBSOLETE.

    APD LC v1.01ES

    Plan of Action (Outlines actions that the subordinate will do after the counseling session to reach the agreed upon goal(s). The actions must be
    specific enough to modify or maintain the subordinate's behavior and include a specified time line for implementation and assessment (Part IV below)

    Session Closing: (The leader summarizes the key points of the session and checks if the subordinate understands the plan of action. The
    subordinate agrees/disagrees and provides remarks if appropriate.)
    Individual counseled:
    I agree
    Individual counseled remarks:

    disagree with the information above.

    Signature of Individual Counseled:

    Date:

    Leader Responsibilities: (Leader's responsibilities in implementing the plan of action.)

    Signature of Counselor:

    Date:
    PART IV - ASSESSMENT OF THE PLAN OF ACTION

    Assessment: (Did the plan of action achieve the desired results? This section is completed by both the leader and the individual counseled
    and provides useful information for follow-up counseling.)

    Counselor:

    Individual Counseled:

    Date of Assessment:

    Note: Both the counselor and the individual counseled should retain a record of the counseling.
    REVERSE, DA FORM 4856, AUG 2010

    APD LC v1.01ES

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