Health Action Plan Template Page 16
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20Health Action Plan
Name / describe the health issue:
To improve my health I want to achieve the following
OUTCOMES / GOALS:
1.
2.
3.
By When /
To achieve my goals I will take the following
How Often?
ACTION
1.
2.
3.
To achieve my goals I will need the following
By Whom /
How Often?
SUPPORT
1.
2.
3.
In order to check my progress we will
Location
REVIEW
Date of review
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