the wellness worksheet - home - bruce and mindy · workout, 8 minute meditation practice week 5...

The Wellness Worksheet

Answer the following questions honestly and openly. On a scale of 1 to 10 (where 1 is the worst and 10 is the best) assess where you are today for each category. Then list some simple steps you can take to reach the outcome you desire.

1. Is your nutrition health-promoting or disease-promoting?

1. Do you participate in formalized exercise?

2. How often do you move throughout the day?

3. Is your level of stress calm or crazed?

4. Do you have mindful moments throughout your day?

GO: Mindful Moments Worksheet

1. What does mindful mean to me?

1. Where do I want mindfulness to reside in my day?

2. Map out the day with mindful moments.

3. Remember to be mindful in every aspect of my day, even the weird spaces I may want to overlook.

The Behavioral Change Worksheet

1. Identify one simple behavior you would like to change.

2. What are your reasons for wanting to change this behavior?

3. What is your forecasted outcome of this behavior change?

4. Identify barriers and road blocks you may encounter.

5. What is going to be your “nudge” factor?

6. Outline your plan for implementing the behavior change and strategies for overcoming road blocks.

7. Who is your support team?

8. What is your reward? How will you reward yourself along the way

The Nutrition Worksheet

1. What does true health and wellness mean to me in relation to the food I eat and the food I feed my family?

2. Identify my goal.

3. What is my motivation to change my eating habits? What is my why and reasoning list?

4. What are the triggers that can set me back?

5. What do I need to do to change the landscape of my kitchen and my work space in relation to the food I surround myself with?

6. Who is my support team?

7. How will I reward myself along the way?

The Creating The Work In Worksheets This is a sample day for someone who is inactive. How could this person add Work Ins?

Time Activity Environment Work In

7-8 Wake, shower, eat breakfast, and drive to work

Home and Car

8-9 Sit at a desk Office

9-10 Sit at a desk Office

10-11 Walk to bathroom and back to desk. Sit at desk

Office

11-12 Sit at desk Office

12-1 Walk to café, sit for lunch, walk back to desk

Outside and Restaurant

1-2 Sit at Desk Office




5-6 Drive to gm, take a Tabata Bootcamp class, drive home

Car and Gym

6-7 Make and eat dinner Home

7-8 Watch TV Home

8-9 Watch TV and go to bed Home

Fill in this activity chart from the time you wake up to the time you go to bed

Time Activity Environment Work In

7-8

8-9

9-10

10-11

11-12

12-1

1-2

2-3

3-4

4-5

5-6

6-7

7-8

8-9

9-10

1. What times are you most active in your day?

2. What times are you most inactive in your day?

3. What is standing in your way of adding more movement into certain times of your day?

4. What can you do to change these obstacles?

5. During inactive times, what can you do to add more activity?

6. What tools or toys do you have available to you to help you add more movement into your day?

7. Who is your support team?

8. What is your reward and how will you reward yourself along the way?

Add a star sticker for every time you ran, played, jumped, or walked each day

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

The Meditation Worksheet

1. Why do I want to add meditation into my day?

2. What time of day can I dedicate to my practice?

3. Initially, how much time can I dedicate to my practice?

4. What do I see as an obstacle and how might I overcome it?

5. What tools do I need to stay on course?

6. Where else in my day can I create calmness?

7. Who is my support team?

8. What is my reward and how will I reward myself along the way?

The Spreading Seeds of Change Worksheet Theme ____________________________________________________________ Seed ______________________________________________________________ Tidbit #1 ___________________________________________________________ Tidbit #2 ___________________________________________________________ The Challenge_______________________________________________________ Theme ____________________________________________________________ Seed ______________________________________________________________ Tidbit #1 ___________________________________________________________ Tidbit #2 ___________________________________________________________ The Challenge_______________________________________________________ Theme ____________________________________________________________ Seed ______________________________________________________________ Tidbit #1 ___________________________________________________________ Tidbit #2 ___________________________________________________________ The Challenge_______________________________________________________

Theme ____________________________________________________________ Seed ______________________________________________________________ Tidbit #1 ___________________________________________________________ Tidbit #2 ___________________________________________________________ The Challenge_______________________________________________________ Theme ____________________________________________________________ Seed ______________________________________________________________ Tidbit #1 ___________________________________________________________ Tidbit #2 ___________________________________________________________ The Challenge_______________________________________________________ Theme ____________________________________________________________ Seed ______________________________________________________________ Tidbit #1 ___________________________________________________________ Tidbit #2 ___________________________________________________________ The Challenge_______________________________________________________

Monday Tuesday Wednesday

Week 1

Seed card #1, 30-60 minute total body workout, 5 minute

meditation practice, begin and maintain

food log and work in log.

The Three Pillars, 5 minute meditation

practice

Seed Card #2, 30-60 minute total body

workout , 5 minute meditation practice

Week 2

Seed card #4, 30-60 minute total body workout, 6 minute meditation practice


practice



Week 3



practice



Week 4



practice


Week 5



practice


Week 6

Seed card #16, 30-60 minute total body

workout, 10 minute meditation practice


practice



Week 7




practice



Week 8




practice



Thursday Friday Saturday Sunday


practice

Seed Card #3, 30-60 minute total body workout, 5 minute meditation practice


practice

Pit Stop: Introspection and

Evaluation


practice



practice


Evaluation


practice



practice


Evaluation


practice



practice


Evaluation


practice



practice


Evaluation


practice




practice


Evaluation


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practice


Evaluation


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practice


Evaluation

The Introspection and Evaluation Worksheet

1. What am I most proud of from this week?

2. In what areas could I have done better?

3. How easy was it for me to stay the course? Did I encounter any road blocks and if so, what did I do to help me move past them?

4. What can I take away as a learning lesson to move forward?

5. What am I looking forward to as I move into this next week? What do I see as a potential concern? What tools will I use to overcome any obstacles?

the wellness worksheet - home - bruce and mindy · workout, 8 minute meditation practice week 5...

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