Counselling Data Sheet

Name of the Student :…………………………………………………………….

ID Number :………………………………………………
Class :………………………………………………
Date of Counselling :……………………………………………..

Counselling Details
1. Issues Discussed with the Student

2. Actions Taken/Advises Given

3. Follow Up Action(s) Taken

4. Outcome of counselling (data to be recorded after one/two weeks of

counselling activities)

Name & Signature of the Counselor: