My Personal Action Plan
BD - II
Name
First Name
Last Name
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Instructor's Name:
Based on what I know now about the effects of alcohol/drugs on traffic safety and the body, the cost, and signs of alcoholism, I plan to make the following changes:
Also:
Stop drinking alcohol and/or using drugs
Separate my drinking/drug use from driving
Have a designated driver
Not drive when taking my medication
Change people, places and alcohol/drug-related activities
I can depend on the following people for support in following my plan:
Family
Spouse
Non-drinking/drug-using friends
AA/NA sponsor
Spiritual leader/higher power
Other
I will get the following benefits from following my plan:
No legal problems related to alcohol/drug use
Healthier lifestyle
Rebuild trust and respect
More money
Freedom
Other
Client ID
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