A LITTLE SPACE FOR YOUR THOUGHTS

My small steps plan

One goal. A manageable first step. A chance to reflect. Complete any sections that help, then print or save your copy.

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All fields are optional. Use your own words. You do not need to enter identifying or health information to use this tool.

Something I want to work towards

Use your own words. It can be big, small or still taking shape.

Up to 1,800 characters

Why this matters to me

What would it change in your day or your life?

Up to 1,800 characters

One small step I want to try

Choose something specific and manageable.

Up to 1,800 characters

Support or adjustments that would help

A person, information, equipment, more time or a different approach.

Up to 1,800 characters

When I might try it

A day, a time or a situation that suits you.

Up to 1,800 characters

When I will check in, and what I will look for

What felt useful? What might you change?

Up to 1,800 characters

Blank PDF

In the print window, choose a printer or “Save as PDF”. On some phones, saving is available under Share. Only the worksheet is printed.

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