1. Home
  2. Health Topics
  3. Search Health Topics
  4. Form for Establishing a Routine

Form for Establishing a Routine

Top of the page

Topic Overview

Use this form to problem-solve and establish a routine.


What is the problem?







What time of day or activity can be used to help you remember?







What are the steps in the routine that you need to make a habit?

1.

2.

3.


What will you use to remind you to follow the routine?







We will keep track of the number of times you follow the routine by:






Plan ways to reward your child for each success. Create bonus rewards for a day in which your child remembers and completes approximately 90% to 100% of a routine.

Credits

Current as ofJune 28, 2018

Author: Healthwise Staff
Medical Review: Adam Husney, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Louis Pellegrino, MD - Developmental Pediatrics

Is it an emergency?

If you or someone in your care has chest pains, difficulty breathing, or severe bleeding, it could be a life-threatening emergency. Call 9-1-1 or the local emergency number immediately.
If you are concerned about a possible poisoning or exposure to a toxic substance, call Poison Control now at 1-800-567-8911.

Thanks to our partners and endorsers:

Northern HealthBritish Columbia College of Family PhysiciansProvincial Health Services AuthorityVancouver Coastal HealthBritish Columbia Medical Association: Doctors of BCIsland HealthCollege of Pharmacists of British ColumbiaCollege of Physicians and Surgeons of British ColumbiaFraser Health AuthorityCollege of Dietitians of British ColumbiaInterior HealthCollege of Dental Surgeons of British ColumbiaBC Centre for Disease Control