Name: Today’s Date:
HPER 1110
Behavior Change Update
Complete the following points to address your progress towards changing your targeted
behavior. The entire form must be completed for full credit.
1. The targeted behavior I am changing is (1):
2. I am using the following behavior change technique(s) (1):
My thoughts on how this/these technique(s) is/are working are (3):
(If the technique(s) you chose to use is/are not working, specify
why and indicate what technique you will try AND WHY.)
3. Based on my final goal, I feel about my progress so
far. This is based on my achievement of my mini-goals as indicated below (3):
Mini-Goal Target Date
1.
2.
3.
4.
5.
4. I have encountered the following obstacle(s) to changing my behavior and taken the indicated
steps to overcome that/those obstacle(s) (3):
Obstacle Actions Taken
5. I would describe my use of tracking tools (charts, graphs, logs, or journals) to monitor my
progress as (Specifically indicate how the use of these tools is proving useful. If not, say so and
indicate what changes you will make to create a more useful monitoring system for yourself.) (4):
