Employee Counselling Form

An employee counselling form is a document used by employers to provide employees with guidance and support during difficult times at work. The form can be used to identify the employee's concerns, assess the situation and provide recommendations for resolving the issue.

2 minutes to complete


The Employee Counselling Form is available for all employees. If any employee is dealing with work-related concerns or problems they can fill out this form.


Questions for Employee Counselling Form



Employee Name

The answer should be a text input.

Phone Number

The answer should be a phone number.

Email ID

The answer should be an email input.


The answer should be a text input.

Supervisor's Name

The answer should be a text input.

Reasons for Counselling

The answer should be a single choice:
  1. Work Stress
  2. Financial Problems
  3. Work Relationship
  4. Physical Health
  5. Traumatic Events

Could you explain why you're seeking counselling in more detail?

The answer should be a text input.

Do you have any medical condition ?

The answer should be a single choice:
  1. Yes
  2. No

Any history of mental illness in your family?

The answer should be a single choice:
  1. Yes
  2. No

Are you referring someone else as a counsellor?

The answer should be a single choice:
  1. Yes
  2. No

Are you comfortable discussing personal issues with your supervisor?

The answer should be a single choice:
  1. Yes
  2. No

Please sign below to confirm that the information you have provided is correct to the best of your knowledge.

The answer should be a signature.

Forms Similar to Employee Counselling Form

  • Employee Conflict Resolution Form
  • Employee Assistance Program Request Form
  • Employee Discipline Form
  • Employee Grievance Form
  • Employee Performance Evaluation Form
  • Employee Separation Form

Here are some FAQs and additional information
Employee Counselling Form

How often should employees be counseled?

There is no definitive answer to this question as it will depend on the individual needs of the employees concerned. However, it is generally advisable to offer counselling on a regular basis, perhaps once or twice a month, in order to ensure that employees are able to resolve any issues they may be facing.

What topics can be covered in employee counselling?

Employee counselling can cover a wide range of topics, from work-related stress and anxiety to personal issues such as relationship problems or bereavement. Counsellors will work with employees to identify the root cause of their problems and help them to find ways to cope with and resolve these issues.

How confidential is employee counselling?

The confidential nature of employee counselling is one of its key benefits. Counsellors are bound by strict ethical guidelines which protect the confidentiality of their clients. This means that employees can feel safe discussing sensitive personal issues.

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