Counseling Report Counselor's Name* First Last Email Address*You will receive a copy of this counseling report for your own records. Counseling Assistants?*If you had the assistance of any other counselors, then select "Yes" and add their names below. Use the "+" icon to add more rows for names, if needed.NoYesCounseling Assistant Name(s)*FirstLast Report DetailsPerson's Name*The name of the individual you met with. First Last More than one person in this counseling report?*If this report is about meeting with more than one person (i.e., a spouse) then select "Yes" and add their names below. Use the "+" icon to add more rows for names, if needed.NoYesOthers Present*FirstLast Meeting Date* Date Format: MM slash DD slash YYYY Meeting Place*Meeting Notes*Do you have another meeting set up?*A follow-up meeting, or another necessary meeting coming out of this counseling session.YesNoNot neededNext Meeting Date* Date Format: MM slash DD slash YYYY