MY ARTHRITIS PLAN

1. MY ARTHRITIS PLAN • 1. How are you doing with your Arthritis (Joint Pain, Swelling, Stiffness, Fatigue)? • □ Excellent□Good□Not Good □Not Sure • I am doing well with:3. I want to do better with: • □Exercising□Exercising • □Eating better foods□Eating better foods • □Managing pain □Managing pain • □Protecting my Joints □Protecting my Joints • □Managing flare-ups□Managing flare-ups • □Taking my medicine□Taking my medicine • □Cutting down on smoking□Cutting down on smoking • □Reducing my stress/relaxing□Reducing my stress/relaxing • □Drinking less alcohol□Drinking less alcohol • □Sleeping□Sleeping • □Managing my weight□Managing my weight • □Managing my work□Managing my work • □Managing my social life/hobbies□Managing my social life/hobbies • □Other : □Other :

2. 4. To improve my health, I will work on one of my chosen activities. • Here is what I can do : • How much : • When : • How often : • 5. How important is the activity in Number 4 to me? (circle a number) • Not 1 2 3 4 5 6 7 8 9 10 Very • 6. How confident am I that I will be able to do the activity in Number 4 (circle a number) • Not 1 2 3 4 5 6 7 8 9 10 Very