Wellness Goals Form

Write about your three SMART (Specific, Measurable, Attainable, Realistic & Timely) personal wellness goals below and receive credit for the "Other" category of the Wellness Passport. Your goals can be anything you want them to be! Examples: I will drink 8 glasses of water a day for the next month, I will go for a walk at lunch at least three times a week for the next four weeks, etc.

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Name *

First

Last

KP Email: *

1st Wellness Goal: What is your goal? Why is it important to you? How do you plan to achieve it? *

2nd Wellness Goal: What is your goal? Why is it important to you? How do you plan to achieve it? *

3rd Wellness Goal: What is your goal? Why is it important to you? How do you plan to achieve it? *

Is there anything we can do to help you achieve your goal? *

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Wellness Goals Form

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