Lifestyle Adaptation Worksheet

1) SMART GOAL Specific Motivating Achievable Realistic Trackable

My goal is ________________________________________________________________________________________________________________________________________________________________________________________________________________________

2) Practice an active lifestyle.

I will do some form of natural activity (gardening, going for a walk, playing a sport) at least

1 2 3 4 5 6 7 times a week. (Circle a number)

3) Right now I exercise an average of 0 1 2 3 4 5 6 7 times a week. (Circle a number)

I will increase that amount to ____ times a week.

4) The most confusing thing about exercise to me is ________________________________________________________________________________________________________________________________________________

5) My biggest obstacle in exercising regularly is ________________________________________________________________________________________________________________________________________________

6) I will over come this obstacle by

________________________________________________________________________________________________________________________________________________

7) My worst eating habit is

Over eating at meal time

Under eating at meal time

Eating to fast

Missing snacks

Eating late at night

8) I will over come this obstacle by

________________________________________________________________________________________________________________________________________________

9) The three parts to a balanced fitness program are Strength, Aerobics, and Flexibility.

If you are missing one or more parts to this program, which one will you work over the next few weeks? __________________________________________________________