Planning for Change

Even when you have committed to change, you still may have mixed feelings at times. Making a written “change plan” will help you to solidify your goals, why you want to reach them, and how you plan to do it. A sample form is provided below. After filling it in, you can print it or email it to yourself.

A sample form is provided below. After filling it in, you can print it out.

Goal: (select one)

I want to drink no more than

drink(s) on any day, and no more than

drink(s) per week (see U.S. Dietary Guidelines)

I want to stop drinking.

Timing: I will start on this date:

Reasons: My most important reasons to make these changes are:

Strategies: I will use these strategies:

People: The people who can help me are (names and how they can help):

Signs of success: I will know my plan is working if:

Possible roadblocks: Some things that might interfere and how I'll handle them

Roadblocks:

How I'll handle them:

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Thinking about a change?

Planning for Change

Download or order the free 20-page booklet, “Rethinking Drinking: Alcohol & Your Health”.

Disponible en Español
Descargue o ordene copias gratis del folleto de 20 páginas ‘Piénselo Antes de Beber: El Alcohol y su Salud’.