Personal Behavior Contract 5 printable pdf download

Personal Behavior Contract 5

Personal Behavior Contract

Based on an awareness of my health status, I,

have decided to set the following behavior-related health goal, which will contribute to improve

my personal well-being.

My health behavior goal is

(long-term SMART goal)

The advantages of my achieving this goal are

The anticipated difficulties in taking positive action are

The behaviors I will adopt to accomplish this personal health goal are

(short-term SMART goals)

I will reinforce my actions by

and reward achievement of my goal by

If I fail to achieve this health improvement goal, I will forfeit this reward.

, have reviewed this contact and

agree to be a part of a positive support system throughout this behavior change project.

Signed

Date

I have reviewed this contract and agree to take action to accomplish my goal and to discuss

the results with my positive advocate. Upon completion of this contract I will identify my next

area of opportunity and take further steps to improve my health status.

Signed

Date

Personal Behavior Contract 5