Form for Establishing a Routine

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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 of: October 24, 2023

Author: Healthwise Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.