Employee Counseling Form

Manage workplace issues confidently using our simple but effective employee counseling form for employees, employers, or supervisors.

By Nate Lacson on Aug 2, 2025.

Fact Checked by RJ Gumban.

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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.

Employee Counseling Form Template

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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.

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.

Benefits of Employee Counseling Form Templates

Standardize your employee counseling process

Using the same counseling template for all your employee counseling sessions ensures you give all employees the same opportunity to be heard. Employee counseling can be delicate, particularly if you are not experienced in counseling as a manager or supervisor, and so having a set template for your employee counseling forms can give you peace of mind that you are treating your employees equally.

Improve your organization skills

Having a paper-trail recording of dates, times, meetings, incidents, and people involved is crucial for managing a workplace issue in a professional way. Our employee counseling form helps you keep all of this important information organized, and ensures it will be easily accessible when you need it.

Provide evidence to third-parties

While we hope that workplace issues can be rectified so both employer and employee are satisfied, on occasion workplace issues may escalate to legal situations. In these situations, it's important you have evidence of the employee counseling provided, which is where our employee counseling form can be a great tool to have.

Keep your documentation digital

Our employee counseling form can be filled out completely digitally using interactive text boxes. Keeping this form digital improves the security and accessibility of the document, and ensures copies aren't left in places they shouldn't be!

Structure your session

Finally, this employee counseling form can help to guide the structure of the employee counseling session itself. By starting with the big picture reason for the counseling, then unpacking the incident, developing a corrective plan, and giving the employee time to respond, you have a preset structure for your session ready to go when you use this form.

Standardize your employee counseling process and improve organizational skills with our structured counseling form templates. Whether you're implementing an action plan, developing a corrective action plan, or managing sessions, our digital forms ensure thorough documentation and ease of access. Explore our counseling practice management software and related tools to enhance your counseling practices and streamline workplace management.

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.