| Goal Setting
- This section includes materials related to self management goal setting. It includes goal setting forms for patients and providers, assessment forms, education material and more, all organized by the nature of their use.
Assessment Materials, Forms & Instruments
Action Plan Card English (Galveston County Health District)
Action Plan Card Spanish (Galveston County Health District)
Action Plan Form English (Galveston County Health District)
Action Plan Form Spanish (Galveston County Health District)
Goal Follow Up Form (Galveston County Health District)
Goal Setting Assessment Tool (Richland County Health Department)
Goal Setting Form and Tips English/Spanish (Gateway Community Health Center)
Goal Setting Support Tool (Richland County Health Department)
Nutrition Goal Setting Form (Minneapolis American Indian Center)
Ready for Change Worksheet (Galveston County Health District)
Self Management Goal Follow Up Form (Galveston County Health District)
Self Management Goal Form (Galveston County Health District)
Self Management Goal Form English (Community Health Center)
Self Management Goal Form Spanish (Community Health Center)
Weekly Action Plan Form (Richland County Health Department)
Patient Education Material
Self Assessment and Action Planning Guide: A1Cs, Sick Days, Feet, and Flu (Dept. of Family and Comm. Health/Marshall University)
Self Management Goal Setting Tri Fold English (Community Health Center)
Self Management Goal Setting Tri Fold Spanish (Community Health Center)
Steps to an Action Plan English (Galveston County Health District)
Steps to an Action Plan Spanish (Galveston County Health District)
TTM Patient Brochures on Checking Blood Sugar (La Clinica de La Raza)
TTM Patient Brochures on Checking Blood Sugar Spanish (La Clinica de La Raza)
TTM Patient Brochures on Exercise (La Clinica de La Raza)
TTM Patient Brochures on Exercise Spanish (La Clinica de La Raza)
TTM Patient Brochures on Meal Planning (La Clinica de La Raza)
TTM Patient Brochures on Meal Planning Spanish (La Clinica de La Raza)
TTM Patient Brochures on Taking Medicine (La Clinica de La Raza)
TTM Patient Brochures on Taking Medicine Spanish (La Clinica de La Raza)
Program Management & Implementation
Goal Setting Contact Sheet (La Clinica de La Raza)
Goal Setting Form (Gateway Community Health Center)
Goal Tracking Form (Galveston County Health District)
Guide to Stages of Change Interventions English (La Clinica de La Raza)
Guide to Stages of Change Interventions Spanish (La Clinica de La Raza)
Self Management Call Back Cards (St. Peter Family Medicine Residency)
Self Management Goal Quality Poster (St. Peter Family Medicine Residency)
Self Management Goal Tracking Sheet (Community Health Center)
Take Action: My Action Plan Lesson Plan and Student Material (Galveston County Health District)
Take Action: Ready for Change Lesson Plan, Student Material and Food Diary and Behavior Worksheets (Galveston County Health District)
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