Accountability Check-In

Let's review how this week has been going for you and think about steps you could take in the next few days!

Intention + Focused Action = Success

Please complete this form to

let me know how you're doing!

First name*

How are you feeling regarding aligned action toward your goals this week?

Tell me what you're feeling good about. Describe steps you've taken in the right direction. Remember to celebrate even the smallest steps. *

Which goal(s) are you stuggling with? Is there something you keep wanting to get to but haven't? Ex.- Health, social, academic, organizational...please describe. *

What do you think has gotten in the way of your success? *

Forgetfulness

Lack of motivation

Distractions- TV/friends

Distractions- Phone/social media

Laziness

Lack of time

Lack of energy

Anxiety or depression

Sick

Avoidance

Disorganization

Other (describe): __________________________________________________________________

Have you tried strategies we've talked about? Please describe what you've tried. *

What do you think you could do that might help you get back on track? Think about strategies we've talked about and consider trying someting.*

Do you think a quick call/text could be helpful?*

Name one or two steps that you'd really like to take between now and our next appointment. *

Celebrate all progress you've made

and think about priorities for the upcoming week!

SCHEDULE AN APPOINTMENT

ONLINE SESSIONS

marlene@marlenebarardo.com

682.337.9390

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