COUNSELING WORKSHEET

References: NAVMC 2795 (Guide to Counseling), MCI 8002, MCI 7104, IRAM, MCO P1610.7E (PES)
A. ADMINISTRATIVE INFORMATION
Marine Reported On:
Last Name First Name MI EDIPI Rank DOR PMOS

Occasion: Period Covered:

EPME Assignment Counseling
Marine Performing Counseling
Last Name First Name MI EDIPI Rank Billet

B. Topics Discussed

C. MAJOR ACCOMPLISHMENTS / SIGNIFICANT EVENTS THIS PERIOD

-N/A
D. EVALUATION OF PERFORMANCE THIS PERIOD
-N/A

E. TASKS ASSIGNED NEXT PERIOD / GOALS

F. ADDITIONAL COMMENTS

G. CERTIFICATION
Signature of Marine Counseled Date

Signature of Marine Performing Counseling Date