Sample "Behavior Contract Template"

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Behavior Contract
Contracts can be intimidating because they demand action and outline the boundaries for what
can and cannot take place. By signing a behavior contract, you are formally agreeing to the
importance of your goal and agreeing to a plan for achieving your goal. Simply signing the
contract will help you take your behavior more seriously. A well-designed behavior contract
should include what your goals are, rewards for success, plan for overcoming barriers, and who
is holding you accountable for how you act. Having these items on paper can help you remember
important dates as well as your personal commitment to change.
I agree to: (add goal here)
I will begin my program on:
I plan to reach my goal by:
To accomplish this goal I commit to accomplishing the following short-term goals:
My strategy for managing my barriers is:
My plan for preventing relapse is:
After achieving my goal I will give myself the following reward:
My support during this process will be:
I understand that it is important for me to make a strong personal effort to make the change in
my behavior. I sign this contract as an indication of my personal commitment to reach my goal.
Signature:
_____________________________________
Date _____________
Witness:
_____________________________________
Date _____________
Behavior Contract
Contracts can be intimidating because they demand action and outline the boundaries for what
can and cannot take place. By signing a behavior contract, you are formally agreeing to the
importance of your goal and agreeing to a plan for achieving your goal. Simply signing the
contract will help you take your behavior more seriously. A well-designed behavior contract
should include what your goals are, rewards for success, plan for overcoming barriers, and who
is holding you accountable for how you act. Having these items on paper can help you remember
important dates as well as your personal commitment to change.
I agree to: (add goal here)
I will begin my program on:
I plan to reach my goal by:
To accomplish this goal I commit to accomplishing the following short-term goals:
My strategy for managing my barriers is:
My plan for preventing relapse is:
After achieving my goal I will give myself the following reward:
My support during this process will be:
I understand that it is important for me to make a strong personal effort to make the change in
my behavior. I sign this contract as an indication of my personal commitment to reach my goal.
Signature:
_____________________________________
Date _____________
Witness:
_____________________________________
Date _____________
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