NEED A WAY TO KEEP YOURSELF ACCOUNTABLE WITH THE BASICS?

 IT’S AS EASY AS A,B,C!

Fill out this form below to formulate an A (Action) B (Benefits) C (Challenges) Plan for yourself and your child. Once you submit the form, we will email you with the finished product!


Action

What do you see when you picture yourself doing a Basics action that you don't usually do? *

When and where will you do it next? *


Benefits

How will the activity benefit you and your child? *

How will it make you feel? *


Challenges

What challenges could get in the way of following through? *

What steps could you take to overcome these challenges? *

Name *


Email Address *

Phone Number

Signature


Sign your name as a promise to keep these goals

Everything with a (*) is required.