Employee Counseling Form
Manage workplace issues confidently using our simple but effective employee counseling form for employees, employers, or supervisors.
Fact Checked by RJ Gumban.
What is an Employee Counseling Form?
Counseling is a great first-line intervention for an employee who has had a workplace issue, incident, or experiencing challenges related to mental health. However, it can be daunting planning a counseling session as an employer. Whether you are an employee counselor, supervisor, or an employer conducting counseling, our employee counseling form can help ease the stress of the employee counseling process.
An employee counseling form is a great tool for effective documentation of important content retrieved during an employee counseling session. Whether this is just between the manager and the employee, or if involving another person such as a counselor, support person, or witness to an incident, these forms effective organize details from the session. This ensures that a verbal counseling session is recorded as having taken place, and that the next steps or corrective plans are noted in writing so there is a clear record of the employee counseling process.
By integrating this resource within your company or protocols, issues related to mental health, company practices, behavior, or other related details can be assessed to determine causes and effective solutions to address these challenges. This will not only enhance an employee's experiences and wellbeing, but enhance the culture of your company overall.
Our form is available as a PDF download and can be filled out either during or immediately after an employee counseling session to document the actions and topics discussed. For more detailed instructions on how to use this form, just keep reading.
Printable Employee Counseling Form
Download these templates for an employee counseling form to improve your therapy intake process and HIPAA compliance.
How to use this template for Employee Counseling Forms
So you've got an employee counseling session booked, what next? Just follow these simple steps to utilize our employee counseling form in your next counseling session.
Step 1: Fill in employee information
The first step is to fill in the employee's information. This includes their name, job title, department, manager's name, date of the workplace incident/issue, and the names of any others present at the counseling session for record-keeping purposes. Take the time to fill in this section carefully as it could be used as evidence down the line.
Step 2: Select the reason for the counseling session
We have provided a few common reasons for an employee counseling session, but if none of these are applicable to the employee, feel free to add the reason under the “other” checkbox.
Step 3. Fill out the next two sections
The next two sections are for the bulk of your record of the counseling session. The description of the workplace issue should be specific, non-judgmental in tone, and factual in nature. Include specific dates and times as relevant. The second main section is the summary of the corrective plan of action. This could include specific actions to be taken to rectify the workplace issue, any disciplinary action, consequences for failing to comply with the corrective plan of action, or any other interventions to help the employee rectify this issue.
Step 4: Have the employee fill out their statement
It's important the employee feels heard during this process, so allow them the chance to make a statement and voice their point of view in the employee statement section. Having their response to the workplace issue and counseling session down in writing helps to capture a holistic view of the employer-employee relationship.
Step 5: Signatures and document storage
Once the rest of the sections are filled in, have the relevant parties sign the document in the space provided at the bottom of the form. If a witness is present, they can sign in the space provided, or this space could be filled in by a mediator, counselor, or another person present at the counseling session. Finally, make and distribute copies of the document to the manager/supervisor, employee, employer's HR department, and anyone else involved in the employee counseling session. It's important that this counseling form is stored securely, whether physically or digitally, as it contains sensitive and confidential information.
Employee Counseling Form Example (Sample)
Not sure of what sorts of things to include in this form? Just take a look at our example employee counseling form completed using this template. This is a (fictional!) counseling form completed for an employee struggling with tardiness. While your employee counseling form will likely look different as every workplace issue and employee is different, this sample form can give you an idea of what a finished employee counseling form may look like.
Download this Employee Counseling Example (Sample) here:
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Who can use the Employee Counseling Form (PDF)?
Our printable employee counseling form is designed to be used by both experienced employee counselors and employers who may be counseling an employee for the first time. Whatever your background, this form can help you to conduct your employee counseling session in a productive and structured way. Professionals who may find this form useful include:
- Workplace or employment counselors
- EAP counselors
- Managers or supervisors taking on a counseling role
- Workplace mediators or independent third parties
- Employment coaches or mentors.
This form is not targeted towards any industry in particular and is flexible enough to be used in a wide range of situations. The topics being addressed in the employee counseling session could range from tardiness and absence from work to inappropriate behavior or violation of workplace drug and alcohol policies. Whether it's the first intervention with the employee or a follow-up session, this form can help.
Why is this form useful for counselors?
Counseling employees can be difficult and delicate enough as it is without having to worry about your record keeping and documentation. This template is designed to help structure the employee counseling session and has a variety of uses for employee counselors.
Ensure you're making a corrective plan
Using this employee counseling form ensures that every time you counsel employees, you come out of the session with a clear plan for corrective action. This benefits both you and your employees, as they will have a good idea of how they can address the issues raised, and you will have a goal to measure against at follow-up sessions.
Give your employee a chance to respond
We have also included space for your employees to write their responses to the issues discussed. While your employee has the right to respond in writing, or refuse to sign the counseling form, we have included a space for their point of view right in the counseling form to give them the earliest opportunity to voice their feelings. Making your employees feel heard and understood while also conveying the corrective action you require of them can be a delicate balance, and by including this section- we hope you'll find this process a little easier.
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Why use Carepatron for Employee Counseling?
The main purpose of employee counseling forms is to make a record of a verbal counseling session. Without this record, there is no way to recall what was agreed upon in the session objectively, and the corrective action plan could be lost. As such, storing employee counseling forms securely and accessibly is crucial to the workflow of employee counseling. That's where Carepatron can help! We offer HIPAA-compliant, digitally encrypted data storage for all your documents, including your employee counseling forms, and offers a counseling practice management software that can be easily integrated within your practice.
As an all-in-on platform, Carepatron's counseling practice management has features such as appointment scheduling, electronic patient records, and appointment reminders to elevate your practice. Furthermore, by using our software, you can gain access to thousands of resources like this. However ,you but still rest assured that your forms are secure, and easily accessible from our mobile or desktop platforms whenever you need them.
Carepatron is designed to take your practice to the next level by automating and streamlining your administration tasks so you can focus on what you do best. Counselors can access counseling note templates, intake forms, and many more as well as a community of healthcare practitioners around the world.
Commonly asked questions
An employee counseling memorandum is similar to counseling forms, but it generally takes the form of a letter/email recounting the content of a verbal counseling session. This has the same purpose of making a record of the counseling session and putting down in writing what was agreed upon during the session.
If an employee refuses to sign these forms, that’s okay, but you still need to record that they received a copy of the document. The way to do this is to have a witness present to sign that they witnessed the employee receiving the counseling form and they can add the date and time they witnessed it. The space for the witness signature at the bottom of this form can be used for this purpose as well if needed.
This depends on what the manager feels is best for the employee in question. Having a neutral third party such as a counselor could be beneficial, whereas in some situations keeping it simple as just a meeting between the manager and the employee may be best. The employee should be allowed a support person with them if they wish, and any witnesses or involved persons from the incident may also be in attendance.
