FREE 14+ Counseling Statement Forms in PDF

Offering help and guidance are two services that a counselor can do to an individual in need of a counseling session. These professionals are commonly associated with educational institutions, business companies, as well as government departments. Although they have mastered the art of dealing with varieties of issues faced by different people every single day, counselors must also be legally prepared and report their assessments promptly to the authorized people who are involved with their clients or patients. Along with all other legal forms and documents, a counselor needs the representation of a counseling statement form from the patient which is expected to be provided by either his or her school where he or she was enrolled or from the company where he or she is employed.

Corrective Counseling Statement Notice Form

Army Counseling Statement Form

Confidential Counseling Services Statement Form

Counseling Report Invoice Statement Form

What Is a Counseling Statement Form?

Counseling statement forms are documents that show the reason of why an individual is recommended to undergo a counseling session and what range of matters and subjects are to be discussed for his improvement. This form must have the general information of the patient or the client as well as a short evaluation of his or her behavior that needs to be corrected within a span of time. Notice forms and warning forms are often associated with this document as these forms are involved in collecting data for creating an effective plan to aid a client in his or her behavioral, mental and physical state.

Counselor Disclosure Statement Form

Developmental Counseling Statement Form Sample

Counseling Disability Information Statement Form

Employee Counseling Notice Statement Form

What’s In a Counseling Statement Form?

Although counseling statement forms can vary depending on who is the main provider or the organization who will use the form, it must contain the significant areas such as an introduction to the client’s state for the counselor’s assessments before the sessions:

Patient information

This is the prime area of the form which should first be completed with the legal name of the patient along with his or her job title or position if he or she is an employee and the patient’s contact information. The patient’ address and all other details of his or her identity may also be included in this area depending on the company who created the document and on how the counselor will supervise the patient for the session’s completion.

Details of the incident

The date when the incident that leads to the need of using the counseling statement form is required to be stated with the particular location where it happened. An area of the form is allocated for the in-depth description of the witnesses, the patient, and the management themselves. As most statement forms contain only a small allocation for the details, the users of the form can attach or enclose supporting documents and additional sheets to assure that the form is used with accurate statements.

Type of corrective action taken

This area indicates whether the patient has already gone through an investigation, background check, or that he or she had received a written warning from the organization. It is essential that this area will clearly specify the type of action provided for the patient to aid the counselor in determining what additional steps are to be taken to construct a more effective plan and decision for the patient’s betterment.

Violation

The kind of violation that the patient did which affected the individuals in the premises of the organization is to be specified in this area. Promoting a threat to his or her colleagues or breaching the terms of the signed contract agreement of the organization can be included as a violation of the patient.

Report description

This area focuses on gathering the details of the policy which holds the violation under a category. A voluntary statement document from the other people involved in the incident can also be stated in this area to open up a deeper understanding of why and how the patient must be handled or managed. Additionally, the follow-up procedure that the management has provided is also found in this area.

Comments

This contains the comments of the patient and the suggestions of the management for the counselor on what should be done to the patient such as sending the patient out of the company for the sessions or conducting a patient assessment and observation for a specific time range. The patient’s comments can include his or her thoughts on what effects he or she had witnessed right after the incident happened and what he or she thinks would be good for him or her which serves as a mere guide for the counselor for meeting the patient’s needs.

Confidentiality agreement

There are numerous reasons why an individual will not accept an offered counseling session even if it is a recommendation for him or her such as being afraid to be deemed as weak or to be declined in future companies due to the records that he or she had. However, this should not be the problem and the trouble that patients must deal with since an issue which is left unresolved may become bigger and more evident over time. This is why a confidentiality agreement statement is found on the form to assure the patient that all the information on the document is not shared with a third party unless authorized.

Signature block

This is the last section of the form which contains the signature of the patient to signify that he or she had read every statement and that his or her personal information is exact to his o her knowledge. The signatures of the witness who reported the incident to the management is also included in this section along with organization’s authorized personnel who dealt with the issuance of the form. The date when the form was completed should be written beside the signatures to allow the recording personnel in accurately filing the document to the appropriate files and category in the organization.

Employee Counseling Statement Form

Initial Counseling Consultation Statement Form

Military Counseling Notice Statement Form

University Employee Counseling Statement Form

Varieties of Counseling Statement Forms

Counseling statement forms are not limited to employees and employers but also to other entities where a counselor’s service is necessary. The list of the general varieties of counseling statement forms aids you in choosing the kind of document you need:

Counseling Responsibility Statement Form – This is a type of counseling statement which is not meant to cater the patient’s information and the report of the management but the license description and the details of the counselor. By having this form, the counselor can prove that he or she is a licensed professional in dealing with a particular counseling subject such as marriage issues or if he or she had undergone a current training for improving his or her specialty. The license numbers of the counselor are stated beside each therapy and subject category with the dates of when the license was issued. Additionally, a list of the country’s code of regulations is enclosed together with the form to highlight the terms needed to be followed by the counselor.

Counseling Responsibility Statement Form

Disability Counseling Statement Form – Some countries provide allowances to their residents who have successfully submitted a disability allowance application and those who have a disability certificate. With this form, the disabled individual or his or her authorized representative is able to indicate the medical and counseling needs for acquiring a treatment. The counselor’s statement on the form specifies the frequency of the sessions that the individual must take whether they will meet up on a weekly or monthly basis. This also has the number of visits that the individual is recommended along with the date when the sessions should begin, the cost per session and the general information of the counselor.

Disability Counseling Statement Form

Employee Counseling Incident Statement Form – Specifically, this document contains an employee information section for the details of the employee who have been involved in a violation. As there are two general types of counseling in the workplace, formal and informal, the employer must indicate what suits best for the violator and when he or she must start meeting the counselor. A summary of the employee’s statement, the acquired disciplinary action, expectations and the action plan suggested by the management are also aspects which are found on the form.

Employee Counseling Incident Statement Form

Financial Counseling Statement Form – Some people have huge amounts of cash with them. However, they are not able to properly allocate home budget and expenditure funds for their needs. This is when a financial counselor is called out to aid the individual who is in deep trouble with regards to his or her savings and properties. A financial counseling statement form contains the financial information of the counselor’s client, the client’s monthly obligations such as rental fees and outside expenses, as well as the net worth statement of the client. This form can also be used for loan application procedures wherein the borrower needs to enlist his or her properties for the verification of the financial provider.

Financial Counseling Statement Form

Why Do Employers Use Counseling Statement Forms?

Employers provide a counseling statement form to the employees who have violated their company laws and regulations. However, a recommendation that an employee will be taken to a counselor is not applicable for every violation as it will depend on the level or penalty that an employee must face. Nonetheless, the form must be completed in three copies which are for the employee, the company, and the counselor to secure that the parties who are dealing with the issue is able to acquire equal file records.