Free Sample Personal Health Plan Template

Sample Personal Health Plan

Prepared by: [Your Name]


I. Personal Information

Name: Jane Doe
Age: 35
Medical History: Mild hypertension, previous knee injury
Current Health Status: Overweight, sedentary lifestyle


II. Health Goals

Goal Type

Health Goal

Short-Term Goals

Lose 5 pounds within 2 months.

Lower blood pressure to within a normal range (below 120/80 mmHg).

Walk at least 30 minutes per day, 5 days a week.

Long-Term Goals

Achieve and maintain a healthy BMI (18.5–24.9).

Incorporate strength training twice a week.

Improve flexibility and reduce knee pain.


III. Action Plan

A. Exercise Routine

  • Cardio: Brisk walking for 30 minutes, 5 days a week.

  • Strength Training: Bodyweight exercises (e.g., squats, lunges) twice a week.

  • Flexibility: 10-minute stretching routine after every workout.

B. Dietary Adjustments

  • Increase: Intake of vegetables, lean proteins, and whole grains.

  • Reduce: Consumption of processed foods, sugar, and sodium.

  • Hydration: Drink at least 2 liters of water daily.

C. Stress Management

  • Practice deep breathing exercises for 5 minutes daily.

  • Set aside 15 minutes each evening for mindfulness or meditation.


IV. Timeline

A. Month 1

  • Begin daily walking routine and dietary changes.

  • Track blood pressure weekly.

B. Month 2

  • Add strength training exercises twice a week.

  • Evaluate progress toward losing 5 pounds.

C. Month 3

  • Reassess goals and adjust the plan as needed.

  • Schedule a follow-up appointment with a healthcare provider.


V. Resources

A. Tools and Apps

  • Fitness tracker (e.g., smartwatch, pedometer).

  • Nutrition tracking app (e.g., MyFitnessPal).

B. Support System

  • Join a local walking group for motivation.

  • Partner with a friend for strength training sessions.

C. Healthcare Services

  • Consult a dietitian for personalized meal plans.

  • Attend physical therapy sessions for knee rehabilitation.


VI. Progress Tracking

  • Exercise Log: Record the type, duration, and frequency of workouts.

  • Diet Log: Keep a daily food diary.

  • Health Metrics: Track weight, BMI, and blood pressure weekly.


VII. Adjustments

  • Modify exercise routines based on knee pain or other limitations.

  • Revise dietary goals if progress stalls.

  • Incorporate additional resources, such as yoga classes or counseling, as needed.


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