For Teens Only My Goal Setting Worksheet
For Teens Only My Goal Setting Worksheet
Name________________________________
Date_________________________________
1. I want to be able to ________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
2. These are things that are bothering me _________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
3. In order to take charge of my health and life activities, I need to clearly communicate my needs and wishes to these people:
a. __________________________________________________________________
b. __________________________________________________________________
c. __________________________________________________________________
4. In order to take charge of my health and life activities, I need to know more information about the following areas:
a. __________________________________________________________________
b. __________________________________________________________________
c. __________________________________________________________________
5. In order to take charge of my life, I need to be able to do the following:
a. __________________________________________________________________
b. __________________________________________________________________
c. __________________________________________________________________
6. What are some "speed-bumps" that might delay meeting my goals?
a. __________________________________________________________________
b. __________________________________________________________________
c. __________________________________________________________________
7. In order to succeed, I am going to ask for help from the following people and agencies:
a. __________________________________________________________________
b. __________________________________________________________________
c. __________________________________________________________________
Adapted from: Life Options Rehabilitation Program

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