Family Care Plan Counseling


Purpose of Counseling

Event Oriented: IAW AR 600-20 Para 5-5, as a new mother and single parent, you are required to have a Family Care Plan on file to ensure the care of your dependant in the event of deployment.

Complete this section during or immediately subsequent to counseling.

As a new mother, you have new and additional responsibilities. You are responsible for the care of your dependent under all circumstances including when you are deployed. Because deployments are unscheduled and delays are unacceptable, it is imperative that all Soldiers plan ahead to ensure they have a plan in place to provide care for their dependents in the event of a deployment. The Army provides a list of tasks to be accomplished to assist you in this preparation. See DA Form 5304, Family Care Plan Counseling Checklist, for more guidance.

Your Family Care Plan must contain the following forms (completed and current):

_____DA Form 5305-R (Family Care Plan)

_____DA Form 5841-R (Power of Attorney)

_____DA Form 5840-R (Certificate of Acceptance as Guardian or Escort)

_____DD Form 1172 (Application for Identification Card-DEERS Enrollment) for each Family member

_____DD Form 2558 (Authorization to Start, Stop, or Change an Allotment)

_____Letter of Instruction to the guardian/escort

_____DA Form 7666 (Parental Consent) -if appropriate

_____DA Form 5304-R (Family Care Plan Counseling Checklist)

You have 60 days from the date of this counseling to complete your Family Care Plan. If you don't understand what the forms require, get with me and we will figure it out. If you fail to complete your Family Care Plan on time, administrative actions may be initiated such as a bar to reenlistment or separation from the military. You are required to keep your Family Care Plan current and update it when there are changes such as the change of the designated care taker. You are also required to conduct a yearly review of the Family Care Plan for accuracy on your birth month.

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  DA FORM 4856-E, JUN 99                         EDITION OF JUN 85 IS OBSOLETE

Plan of Action:

SPC Jones understands the critical importance of readiness and the role of the Family Care Plan in ensuring her unit is ready to deploy and execute its mission within 24 hours, if necessary.

See MSG Smith, the unit Family Care Plan counseler for help in completing the required forms. The package must be completed within 60 days. After completion, we will submit the completed package to the Commander for approval.

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: _26 Apr 2013_

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

Follow up in 30 days to guage SPC Jones' progress

Review the Family Care Plan before submission to the Commander

Provide guidance and support as needed to SPC Jones

Signature of Counselor: _ _ _ _ _ _ _ _ _ _ _ Date: _26 Apr 2013_

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)

SPC Jones has completed the Family Care Plan package and is ready for deployment. In addition, her preemptive efforts have provided an unexpected confidence in her ability to meet her obligations to the Army and a corresponding increase in morale and motivation.

Counselor: _ _ _ _ _ _ _ _ _ _ Individual Counseled: _ _ _ _ _ _ _ _ _ Date: _ _ _ _ _ _

Note: Both the counselor and the individual counseled should retain a record of the counseling.

  DA FORM 4856-E (Reverse)                    

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