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The subordinate agrees/disagrees and provides remarks if appropriate.) Individual counseled: I agree disagree with the information above Individual counseled remarks: Signature of Individual Counseled: Date: Leader Responsibilities: (Leader s responsibilities in implementing the plan of action.) Signature of Counselor: Date: Part IV - ASSESSMENT OF THE PLAN OF ACTION Assessment: (Did the plan of action achieve the desired results This section is completed by both the leader and the individual counseled and provides useful information for follow-up counseling.) (When the plan of action is complete, use this area to explain the outcome..