SMART Goal Worksheet

Use this worksheet to create a clear, realistic goal that supports your health and well-being.

Remember, always consult with your healthcare provider first before making significant lifestyle or dietary changes, or starting any new exercises.

Step 1: What Is One Health Goal I Want to Work On?

Example areas:

• Physical activity
• Healthy eating
• Blood sugar monitoring
• Stress management
• Sleep improvement
• Medication consistency

My goal area:

Step 2: Write Your SMART Goal

Use this formula:

By __________________ (date/time frame),
I will _________________________________________________

How often? _____________________________________________
For how long? ___________________________________________

Step 3: Break It Down

S – Specific

What exactly will I do?

M – Measurable

How will I know I accomplished it?

A – Achievable

Is this realistic for me right now? What might get in the way?

R – Relevant

Why does this goal matter to me?

T – Time-Bound

When will I start? When will I review my progress?

Start Date: _____________________
Review Date: _____________________

Step 4: Identify Support & Planning

What will help me succeed?

☐ Reminder on phone
☐ Support from family or friend
☐ Calendar tracking
☐ Preparing in advance
☐ Setting out clothes/equipment
☐ Other: _________________________

Step 5: Track My Progress

Day	Completed? (Yes/No)	Notes

Weekly Reflection

What went well?

What was challenging?

What will I adjust next week?

Encouragement

Small steps add up. Progress — not perfection — leads to lasting change.

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Medical Disclaimer

This worksheet is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Individuals should consult their physician or qualified healthcare provider before making significant lifestyle or health changes. Always follow individualized medical guidance and report any concerning symptoms to your healthcare team. Call 911 if you are experiencing a medical emergency.