Back to Counseling Page |
![]() |
| PART II - BACKGROUND INFORMATION | |
|
Purpose of Counseling |
|
| PART III - SUMMARY OF COUNSELING Complete this section during or immediately subsequent to counseling. |
|
|
|
| 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DA FORM 4856-E, JUN 99 EDITION OF JUN 85 IS OBSOLETE space |
|
Plan of Action: ____I will devote the majority of my efforts and time to becoming qualified in my position. ____I will participate in all scheduled physical conditioning activities.
|
|
| Session Closing: (The leader summarizes the key points of the session and checks to ensure 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:
Signature of Individual Counseled: ____________________________________ Date: ___13 May 2011__ |
|
| Leader Responsibilities: : (Leader’s responsibilities in implementing the plan of action) I will monitor your progress and will provide guidance and assistance whenever you request or need it.
Signature of Counselor: ____________________________________ Date: ___13 May 2011__ |
|
| 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)
space Counselor: ______________________ Individual Counseled: ____________________ Date of Assessment:_________________ |
|
| Note: Both the counselor and the individual counseled should retain a record of the counseling. |
|
DA FORM 4856-E (Reverse) space |
Contact editor@armywriter.com