A printable self-care goal planner can help turn wellbeing check-ins into small, manageable actions across sleep, relaxation, movement, food, drinks, smoking, alcohol, digital habits and social time. The blank goal-setting form is suited to adults who want a simple wellbeing MOT, as well as practitioners, support workers and counsellors helping someone choose realistic self-care targets.
The Self-Care Goal Setter MOT blank form PDF is a simple printable worksheet for reviewing everyday wellbeing habits and choosing small actions to work on. It uses a structured MOT-style layout across five areas: Battery recharge, Movement, Fuel, Fluids & exhausts, and Weekly maintenance. The prompts cover practical self-care ideas such as building a bedtime routine, trying breathing or mindfulness, moving more, cooking nutritious meals, drinking water, reducing caffeine, cutting down on alcohol, taking screen-free time, getting outdoors and planning social contact.
The blank goal-setting table gives space to write personal actions, making it useful for adults who want a straightforward self-care plan without a long written exercise. It can also support guided conversations in wellbeing appointments, counselling sessions, social prescribing, coaching, peer support or one-to-one work with a practitioner. Because the form is flexible, goals can be kept small, specific and realistic for the person using it.
Use it as a downloadable self-care worksheet, wellbeing MOT form, lifestyle habits planner or weekly goal-setting template. It can be printed for home learning, added to a wellbeing pack, used during a support session, or revisited later to check whether chosen actions still feel realistic and helpful. This resource was created by MindWell Leeds.
