Personal Health Plan
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Confidential and Proprietary - © 2018 Duke Integrative Medicine
You: Discovering Your Health Goals
You are the ultimate owner of your life and your health. Being in the driver’s seat requires a good
map. It is important to know your starting point and your destination. This means knowing what
your health is like now and what you would like your health to be going forward. This may be a
new way to think about your health. Many of us are used to thinking about our health only when
we are sick. Whole person health and well-being means understanding what your life goals are
and what contributes to your sense of wellness over time.
A personal health inventory will follow this introduction. Please take time to think about where you
are now and where you want to be. Your health coach will review this personal health inventory
with you and use it as a tool to help you plan for your health in a way that fits your unique life and
goals.
Personal Health Plan
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Confidential and Proprietary - © 2018 Duke Integrative Medicine
Personal Health Plan
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Confidential and Proprietary - © 2018 Duke Integrative Medicine
Personal Health Inventory
For: ___________________________
Date: __________________________
The first step in creating your plan is to complete a personal health inventory to assess where you
are now and where you want to be.
1. How do I picture my best health?
How would I like to feel and look? What activities would I like to be able to do?
2. What is most important as I think about the picture of my best health?
Personal Health Plan
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Confidential and Proprietary - © 2018 Duke Integrative Medicine
3. For each area, please take a moment to think about where you are now and where you
would like to be. Please complete as many of the boxes as you can. You may want to start
with the areas that are most interesting to you at this time. It is okay to just circle a number
for each box, if you prefer.
Mindful Awareness
Awareness of the present moment; paying attention to what you are doing while you ar
e doing
it.
Where are you now?
On a scale of 1 (low) to 10 (high), how would you
rate this area of your life?
1 2 3 4 5 6 7 8 9 10
Why did you choose this number?
Where would you like to be?
1 2 3 4 5 6 7 8 9 10
What changes could you make to help you get
there?
Movement, Exercise and Rest
Activities of daily living such as cleaning and gardening; exercise activities such as dancing,
yoga, walking, running, and cycling; adequate rest and relaxation.
Where are you now?
On a scale of 1 (low) to 10 (high), how would you
rate this area of your life?
1 2 3 4 5 6 7 8 9 10
Why did you choose this number?
Where would you like to be?
1 2 3 4 5 6 7 8 9 10
What changes could you make to help you get
there?
Personal Health Plan
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Confidential and Proprietary - © 2018 Duke Integrative Medicine
Nutrition
Eating a balanced, healthy diet.
Where are you now?
On a scale of 1 (low) to 10 (high), how would you
rate this area of your life?
1 2 3 4 5 6 7 8 9 10
Why did you choose this number?
Where would you like to be?
1 2 3 4 5 6 7 8 9 10
What changes could you make to help you get
there?
Personal and Professional Development
Growing and developing your abilities, talents, and interests, both in your personal life and at
work; living with both in balance.
Where are you now?
On a scale of 1 (low) to 10 (high), how would you
rate this area of your life?
1 2 3 4 5 6 7 8 9 10
Why did you choose this number?
Where would you like to be?
1 2 3 4 5 6 7 8 9 10
What changes could you make to help you get
there?
Personal Health Plan
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Confidential and Proprietary - © 2018 Duke Integrative Medicine
Physical Environment
Spaces where you live and work (including
safety, light, noise, toxins, and color), as well as
landscapes surrounding those spaces.
Where are you now?
On a scale of 1 (low) to 10 (high), how would you
rate this area of your life?
1 2 3 4 5 6 7 8 9 10
Why did you choose this number?
Where would you like to be?
1 2 3 4 5 6 7 8 9 10
What changes could you make to help you get
there?
Relationships and Communication
Spending time with family, friends, and/or co-
workers who are supportive and with whom you
communicate effectively.
Where are you now?
On a scale of 1 (low) to 10 (high), how would you
rate this area of your life?
1 2 3 4 5 6 7 8 9 10
Why did you choose this number?
Where would you like to be?
1 2 3 4 5 6 7 8 9 10
What changes could you make to help you get
there?
Personal Health Plan
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Confidential and Proprietary - © 2018 Duke Integrative Medicine
Spirituality
Seeing purpose and meaning in something larger than yourself. This might include religious
affiliation or other areas such as nature or the arts.
Where are you now?
On a scale of 1 (low) to 10 (high), how would you
rate this area of your life?
1 2 3 4 5 6 7 8 9 10
Why did you choose this number?
Where would you like to be?
1 2 3 4 5 6 7 8 9 10
What changes could you make to help you get
there?
MindBody Connection
Paying attention to the connection between the mind and body and the
effects they have on
each other. Using techniques such as breathing and stress reduction practices to help the body
relax and heal.
Where are you now?
On a scale of 1 (low) to 10 (high), how would you
rate this area of your life?
1 2 3 4 5 6 7 8 9 10
Why did you choose this number?
Where would you like to be?
1 2 3 4 5 6 7 8 9 10
What changes could you make to help you get
there?
Personal Health Plan
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Confidential and Proprietary - © 2018 Duke Integrative Medicine
Professional Care: Prevention and Intervention; Conventional and
Complementary Approaches
Routine screenings such as
mammograms, prostate screenings, colonoscopies, pap tests and
dental exams, along with prescribed use of vitamins and supplements. Following treatments
recommended by your conventional medical care providers as well as recommended
complementary approaches such as acupuncture, massage, hypnosis, and osteopathy.
Where are you now?
On a scale of 1 (low) to 10 (high), how would you
rate this area of your life?
1 2 3 4 5 6 7 8 9 10
Why did you choose this number?
Where would you like to be?
1 2 3 4 5 6 7 8 9 10
What changes could you make to help you get
there?
4. What stands out for you as significant about where you currently are in any given area
of the Wheel of Health?
Personal Health Plan
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Confidential and Proprietary - © 2018 Duke Integrative Medicine
5. If nothing changes in your health and well-being choices, what do you think your health
will be like three years or ten years from now? What would be the worst-case scenario?
6. If you make significant health behavior changes, what do you think your health will be
like three years or ten years from now? What would be the best-case scenario?
Personal Health Plan
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Confidential and Proprietary - © 2018 Duke Integrative Medicine
7. Place an X in the column that indicates when you would like to begin working on that
area. If you do not anticipate a change in any given area, place an X in the last column.
Area of Wheel of
Health
Within the
next three
months
next year
three ye ars
desired
Mindful Awareness
Movement,
Exercise, and Rest
Nutrition
Personal and
Professional
Development
Physical
Environment
Relationships and
Communication
Spirituality
MindBody
Connection
Professional Care:
Prevention and
Intervention
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