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Coaching and Counseling Form Rev

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Yuzu Ann
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14 views

Coaching and Counseling Form Rev

form

Uploaded by

Yuzu Ann
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 3

COACHING / COUNSELING FORM

TO: THIS FORM HAS BEEN DESIGNED TO RECORD THE THOUGHTS AND ITEMS THAT NEED TO
BE DISCUSSED IN THE COACHING SESSION SO THAT THE CONVERSATION IS PRODUCTIVE
SUPERVISOR / MANAGER & AND EFFICIENT AND ALL POINTS ARE COVERED SUFFICIENTLY.
EMPLOYEE THE INFORMATION DISCUSSED BETWEEN THE EMPLOYEE AND SUPERVISOR OR
MANAGER SHOULD REMAIN CONFIDENTIAL AND BE SHARED ONLY WITH THOSE WHO
HAVE A LEGITIMATE NEED TO KNOW, WHICH INCLUDES HR & YOUR MANAGER/VP IF
APPROPRIATE.
SUPERVISOR/MANAGER NAME
TITLE
CLIENT
COACHING VIA IN PERSON TELEPHONE
SUPERVISOR/MANAGER SIGNATURE
TODAY’S DATE

RE: EMPLOYEE
EMPLOYEE NAME
ASSIGNMENT/POSITION/TITLE
CLIENT

FOR EACH CONCERN TO BE DISCUSSED, DOCUMENT THE FACTS


FACTS ABOUT ISSUES OR BEHAVIORS BEING THAT OCCURRED INCLUDING AS MANY DETAILS AS POSSIBLE. USE
DISCUSSED ADDITIONAL PAGES IF NECESSARY.

SUMMARY OF ISSUES OR BEHAVIOR TO BE DISCUSSED

OBJECTIVES TO ACCOMPLISH DURING THE DISCUSSION

DATE(S) THE ISSUES OR BEHAVIORS TOOK PLACE

HISTORY OF PREVIOUS DISCUSSIONS ABOUT THESE ISSUES

LIST WITNESSES OR OTHERS INVOLVED IN THE CONCERNS


BEING DISCUSSED

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SOLVING THE PROBLEM LIST FACTS, INFORMATION NEEDED, CONCERNS, POSSIBLE
CAUSES OR REASONS FOR THE SITUATION, ALTERNATIVES,
CONSTRAINTS, AND AVAILABLE RESOURCES.
LIST FACTS, INFORMATION NEEDED FROM EMPLOYEE,
CONCERNS, POSSIBLE CAUSES OR REASONS FOR THE
SITUATION

LIST ALTERNATIVES, CONSTRAINTS, AND AVAILABLE


RESOURCES TO HELP WITH THE ISSUES GOING FORWARD

FUTURE EXPECTATIONS / SPECIFIC ACTIONS TO BE TAKEN

CONSEQUENCES TO EMPLOYEE IF ISSUES/BEHAVIOR


CONTINUES

FOLLOW UP—ESTABLISH A DATE, TIME, PLACE TO FOLLOW


UP WITH THE EMPLOYEE, SCHEDULE THE MEETING, AND
FOLLOW THROUGH.

WERE THERE ANY WITNESSES OR OTHERS INVOLVED WITH


YES NO
THE CONCERNS/BEHAVIORS?
IF SO, WHO?

IS THERE ANYTHING ELSE THAT YOU WOULD LIKE THE


COMPANY TO KNOW THAT YOU FEEL IS RELEVANT TO THE YES NO
CONCERNS OR BEHAVIORS DISCUSSED TODAY?

NOTES FROM THE


CONVERSATION

Page 2 of 3
SUPERVISOR / MANAGER I SPOKE WITH MY EMPLOYEE ABOUT THESE ISSUES.
I WISH TO MAKE AN
ADDITIONAL STATEMENT OR YES NO
COMMENTS BELOW
MY COMMENTS

SUPERVISOR/MANAGER
(PRINT NAME)
SUPERVISOR/MANAGER
SIGNATURE
WITNESS (IF NECESSARY)
(PRINT NAME)
WITNESS SIGNATURE

TODAY’S DATE

EMPLOYEE I SPOKE WITH MY SUPERVISOR OR MANAGER ABOUT THESE ISSUES.


I WISH TO MAKE AN
ADDITIONAL STATEMENT OR YES NO
COMMENTS BELOW
MY COMMENTS

EMPLOYEE NAME
(PRINT NAME)
EMPLOYEE SIGNATURE

TODAY’S DATE

FAX TO HUMAN CAPITAL: (248) 204-0722

Page 3 of 3

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