Get the blank one-page template
Choose the paper size for your printer. Both PDFs have the same prompts and room to write by hand. You can also type into the worksheet below, then use your browser's print command. This page does not submit or store your answers, so print or save a copy if you want to keep them.
Download the A4 self-care plan (PDF) · Download the US Letter self-care plan (PDF)
How to make your plan
- Notice what is happening. Name one ordinary stress point and one thing that usually helps. You can leave either blank if it is not useful.
- Choose up to three small actions. Say what you will do and when. “Walk for ten minutes after lunch on Tuesday” is easier to use than “exercise more”. Include a practical task or a connection with someone if those would help more than another relaxation activity.
- Prepare for a difficult day. Write one likely barrier and a smaller backup action. The backup counts as using the plan, not failing it.
- Review after a week. Keep what helped, change what did not fit, and make the next plan smaller if needed.
Need a day-by-day layout? Build a week with the weekly wellness planner. It lets you choose activities, days and a time budget, then edit or print the result.
A filled example
Here is one possible plan for a busy week. Your actions can be different, and you do not need to fill every line.
| Prompt | Example answer |
|---|---|
| What is taking energy? | Late meetings and little time between work and dinner. |
| What already helps? | A short walk and talking with my sister. |
| Action 1 | Walk for ten minutes after lunch on Tuesday and Thursday. |
| Action 2 | Text my sister on Wednesday to arrange a weekend call. |
| Likely barrier and backup | If a meeting takes my lunch break, walk around the block after work for five minutes. |
| Weekly review | Thursday's walk helped. Tuesday was too crowded, so try Friday next week. |
My self-care plan
These editable blanks are an on-page version of the printable sheet. Nothing is submitted, saved or shared by this page.
Keep it flexible
This is a planning sheet, not a test. Some weeks may call for one action, help from another person, or more rest. If your circumstances change, cross out an action and choose a smaller one. A plan can make a useful next step visible, but it cannot replace personal care or professional support when you need it.