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

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    Deontaye Bibbs
    This document is a developmental counseling form used to assist leaders in conducting and recording counseling sessions with subordinates. It contains administrative data about the soldier and counselor, background information on the purpose of the counseling session, a summary of the key discussion points, a plan of action for the soldier to improve, and an assessment of whether the plan was effective. It provides a structured way for leaders to document counseling and ensure soldiers understand expectations.

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

    Uploaded by

    Deontaye Bibbs
    67 views2 pages
    This document is a developmental counseling form used to assist leaders in conducting and recording counseling sessions with subordinates. It contains administrative data about the soldier and counselor, background information on the purpose of the counseling session, a summary of the key discussion points, a plan of action for the soldier to improve, and an assessment of whether the plan was effective. It provides a structured way for leaders to document counseling and ensure soldiers understand expectations.

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    Emergency Leave

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    This document is a developmental counseling form used to assist leaders in conducting and recording counseling sessions with subordinates. It contains administrative data about the soldier and counselor, background information on the purpose of the counseling session, a summary of the key discussion points, a plan of action for the soldier to improve, and an assessment of whether the plan was effective. It provides a structured way for leaders to document counseling and ensure soldiers understand expectations.

    Copyright:

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

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

    Uploaded by

    Deontaye Bibbs
    This document is a developmental counseling form used to assist leaders in conducting and recording counseling sessions with subordinates. It contains administrative data about the soldier and counselor, background information on the purpose of the counseling session, a summary of the key discussion points, a plan of action for the soldier to improve, and an assessment of whether the plan was effective. It provides a structured way for leaders to document counseling and ensure soldiers understand expectations.

    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 ATP 6-22.1; the proponent agency is TRADOC.
    DATA REQUIRED BY THE PRIVACY ACT OF 1974
    AUTHORITY: 5 USC 301, Departmental Regulations; 10 USC 3013, Secretary of the Army.
    PRINCIPAL PURPOSE: To assist leaders in conducting and recording counseling data pertaining to subordinates.
    ROUTINE USES: 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.
    PART I - ADMINISTRATIVE DATA
    Name (Last, First, MI) Rank/Grade Date of Counseling

    Organization Name and Title of Counselor


    NCOSupport.com
    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.)

    o Emergency Leave Briefing IAW AR 600-8-10

    PART III - SUMMARY OF COUNSELING


    Complete this section during or immediately subsequent to counseling.
    Key Points of Discussion:
    _________( Soldier's Rank and Name) on _______ (date) your request for emergency leave was approved. You are hereby notified of the following procedures and
    actions required in IAW AR 600-8-10: (1). While on leave maintain in your possession the DA Form 31, DD Form 2A (Active) (Active Duty Military ID Card), PHS
    731 (International Certificate or Vaccination), destination clearance, and passport and visa when applicable (see DODD 1000.21 and the DOD Foreign Clearance
    Guide (FCG) (DOD 4500.54-G) for passport and visa requirements). (2) You are to have DA Form 31, blocks 21 and 22, posted at each personnel activity
    transportation area passed through.(3) You must have sufficient funds to defray the cost of travel in or across CONUS or to the area where the emergency exists and
    return. (4) If you have insufficient funds to defray the cost of travel, your are to contact the servicing finance officer to determine if a partial pay will be authorized
    prior to departure (5) Advise Soldier that if he or she is not eligible for a partial pay and has insufficient funds to meet travel needs, to request financial assistance from
    the American Red Cross or Army Emergency Relief (AER) prior to departure. (6) Inform Soldier to contact the nearest American Red Cross chapter should an
    extension of leave be required (7) Brief Soldier that if emergency leave is authorized based on false information, the command can impose administrative or
    disciplinary action or both as deemed appropriate.

    Should you have any problems contact the unit chain of command immediately for the possibility of a leave extension. Please stay in contact with the unit during your
    absence and keep us apprised of the situation. We sincerely hope this issue can be resolved in a positive manner

    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, JUL 2014 PREVIOUS EDITIONS ARE OBSOLETE. Page 1 of 2


    APD LC v1.03ES
    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)
    o Provide Soldier the required briefing IAW AR 600-8-10
    o Explain Procedures for requesting an extension
    o Provide the Soldier a list of phone numbers for the chain of command
    o Encourage the Soldier to call and update the command on the situation.
    o Ensure the Soldier fully understands that they must return at the end of their leave unless granted an extension

    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 disagree with the information above.
    Individual counseled remarks:
    o Brief the Soldier
    o Ensure the Soldier understands the requirements for an extension
    o Assist the Soldier in departing their current location

    Signature of Individual Counseled: Date:

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


    Keep the Soldier informed
    Ensure Commander’s decision is implemented
    Monitor Soldier’s demeanor, performance and interaction with others

    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, JUL 2014 Page 2 of 2
    APD LC v1.03ES

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