Goal Setting Worksheet for Rehabilitation & Corrective Exercise Clients

Use in FirstRep form

Personal Information

Collecting personal details is essential for tailoring rehabilitation programs.

Aa Full Name *

Enter your full name

Aa Email Address *

Enter your email address

Aa Phone Number *

Enter your phone number

Injury/Surgery History

Understanding your injury or surgery history helps in creating a safe exercise plan.

... Type of Injury/Surgery *

Describe your injury or surgery

D Date of Injury/Surgery *

Select date

... Current Symptoms

Describe any current symptoms

Goals and Objectives

Setting clear goals is crucial for motivation and progress tracking.

Aa Primary Goal *

What is your primary rehabilitation goal?

... Secondary Goals

List any secondary goals

Aa Timeline for Goals *

What is your timeline for achieving these goals?

Physical Activity Readiness

Assessing your readiness for physical activity ensures safety during recovery.

v Current Activity Level *

... Previous Exercise Experience

Describe your previous exercise experience

1-10 Fear of Re-injury *

Rate your fear of re-injury from 1 to 10

Support Network

Identifying your support network can enhance your rehabilitation process.

Aa Physical Therapist Contact *

Enter your physical therapist's contact information

Y/N Family Support *

Do you have family support?

... Other Support Resources

List other support resources available to you

Progress Tracking

Tracking your progress helps in maintaining motivation and adjusting goals.

... Weekly Progress Notes

Document your progress each week

... Milestone Achievements

List milestones you want to achieve

Documentation and Communication

Clear communication with healthcare professionals is vital for safe rehabilitation.

... Documentation Requirements *

What documentation do you need to maintain?

v Preferred Communication Method *

Why Use This Template

Focus on Individual Needs

Personalized goals cater to the unique recovery journey of each client.

Enhance Communication

Facilitates better communication with healthcare providers.

How to Use

Fill out personal information to personalize your rehabilitation plan.

Set realistic and measurable goals to track your progress.

Customization Tips

Adjust the goals section to fit specific rehabilitation timelines.
Include additional fields for specific injuries or conditions.
Tailor the support network section to include local resources.

Build and send rehabilitation & corrective exercise templates digitally with FirstRep. Free for up to 3 clients.

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Frequently Asked Questions

How can I ensure my goals are realistic?

Consult with your physical therapist or trainer to set achievable goals based on your current condition.

What if I feel pain during exercises?

Stop the exercise immediately and consult your healthcare provider for guidance.