Exercise Planning Form

No matter what your exercise goal is, making a specific plan can help you be more successful.

Follow these steps to create your plan. Then bring this sheet when you visit your doctor so you can refine your plan together. You may also want a personal trainer or fitness expert who can help you with your exercise goals.

Step 1: Know why you want an exercise goal.

Why is this goal important to you? Make sure it's what you really want to do and like to do.

Step 2: Set a specific long-term exercise goal.

What is a long-term goal that you can reach in about 6 to 12 months?

Step 3: Set your short-term goals.

How can you create short-term goals that you take week by week to reach your long-term goal?

Step 4: Prepare for slip-ups or setbacks.

What might get in the way of your reaching this goal? You may already know that things like time, money, or not liking exercise could get in the way. How might you get around these?

Step 5: Plan for support and rewards.

Who can help you meet your goals? Maybe friends, family, or a walking buddy? And how will you reward yourself? A movie, a special meal, or an hour to yourself can be a treat.

Step 6: Review With My Doctor

Questions to ask my doctor

  • Any health problems I need to keep in mind?
  • Any special tests I need before I start an exercise program?
  • Any exercises I need to avoid?
  • What exercises are safe for me that I know I'll enjoy?
    • Aerobic exercises: How often and how long
    • Flexibility exercises: How often and how long
    • Strength and balance exercises: How often and how long
  • Any warning signs I need to watch for?
  • Should I take my pulse when I exercise? If so, what range is best for me (target heart rate)?
  • Should I change the time I take my medicines?
  • Other questions

See your success!

Creating this exercise plan is your first step to success. Post it in a place where you'll see it, and revisit it as you meet your goals. Nice work!


Current as of: January 26, 2022

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Christine R. Maldonado PhD - Behavioral Health

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