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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.


⚠️ Medical Disclaimer

This resource is provided for educational and informational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. The information presented is general in nature and may not apply to every individual or health situation.

Individuals should consult their physician or other qualified healthcare professional for personalized medical advice, diagnosis, or treatment recommendations related to their specific health conditions and should not begin any new exercise program or change their diet or medications without consulting their healthcare professional.

Call 911 if you are experiencing a medical emergency.