you. will answer the following questions
Behavior Change Contract
Be sure to complete all portions of the activity. This includes defining your overall goal and three incremental goals; logging three benefits to achieving the goals, three barriers to achieving the goals, and three strategies for overcoming those barriers; signing the contract; and rating how important the change is to you and your confidence that you can make the change.
Behavior I want to change: | |
My goal: | |
Remember that your goal should be SMART: specific, measurable, attainable, realistic, and time-bound.
I will achieve my goal by: | |
Along the way, I will create a series of smaller, incremental goals to help me reach my overall goal: |
Incremental goal 1: | | Target date: | |
Incremental goal 2: | | Target date: | |
Incremental goal 3: | | Target date: | |
Benefits associated with this behavior change: |
1 | |
2 | |
3 | |
Barriers I expect to encounter: |
1 | |
2 | |
3 | |
Strategies for overcoming these barriers: |
1 | |
2 | |
3 | |
Your signature: | | Date: | |
|
Witness signature: | | Date: | |