DA 4856 Form

A fillable DA 4856 form is also known as a Developmental Counseling Form. It is completed by counselors who are providing services to US Army soldiers. While this form is completed by a counselor to document the progress of the sessions, it is not information that is ever made available to the public. this document includes information such as the personal information of the soldier, the reason counseling occurred, discussion points, and a plan for the soldier.

What is a Da form 4856?

The DA Form 4856 is a form used by the Department of the Army. It is a Developmental Counseling Form. This form is used to document counseling sessions given from counselors to soldiers in the Army. This form is required for any counseling sessions given to military personnel, although the information included in the form is not publicly disclosed.
A variety of information is needed to accurately fill out this form. The counselor will need the patient's personal information, including name, rank, and organization. The counselor will also need to include their own information on this form. Finally, the counselor will need to include information about the counseling session, including the reason for counseling, what was discussed, and a plan of action for the person receiving counseling services.
Both the counseled and the counselor will need to sign this form. A copy of the DA Form 4856 should be kept by both parties.

How to complete a Da form 4856 (Step by Step)

To fill out a DA Form 4856 form, you will need to provide the following information:
Part I - Administrative Data

  • Name (last, first, middle initial)
  • Rank/grade
  • Date of counseling
  • Organization
  • Name and title of counselor

Part II - Background Information

  • A description of the reason for the counseling (for example: performance/professional, event-oriented, includes leader’s facts and observations prior to the counseling)

Part III - Summary of Counseling (This section should be filled out during or immediately after the counseling)

  • Key points of discussion
  • Plan of action - outline plan of action for subordinate to do to reach the agreed upon goals, actions must be specific enough to modify or maintain the subordinate’s behavior and include a timeline for implementation and assessment
  • Section closing - summarize key points of section and check to ensure subordinate understands, subordinate can agree or disagree and provide their own remarks, subordinate must sign and date
  • Leader responsibilities - describe the leader’s responsibilities in implementing the plan of action, sign and date

Part IV - Assessment of the Plan of Action

  • Explain whether the plan achieved the desired results, section should be completed by leader and individual who is being counseled together
  • Name of counselor
  • Name of individual being counseled
  • Date

Additional Information

  • Additional notation about counseling
  • Name and grade of counselee, signature, date
  • Name and grade of counselor, signature, date

A Form 4856 will be destroyed upon: reassignment (other than rehabilitative transfers), separations at ETS, or upon retirement.

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Sample DA 4856 Form


Sample DA 4856 Form

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