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Action Plan Tracking Template
UseofActionPlanandStepTrackingForm;SampleMedicalEntriesAugust2014
StepTrackingForm:
ThesteptrackingformisanothertoolusedintheAHFprogramtoencourageandtrackdailyphysical
activity.Asshownontheformbelowwhichisforchildandparenttocomplete(1sideforchildandother
sideforparent),thegoalis10,000stepsperday.Thechildandparentrecordtheirstepsdailyandbring
thetrackingformateverysessionfortheAHFstafftoaddupthetotalnumberofsteps.Thechildwiththe
highestnumberofstepsandwithweightlossorweightmaintainedgetsaprize.Seesamplebelow‐
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source: cchealth.org
Action Plan Tracking Template