Goal Design Blueprint Worksheet
Health & Happiness Series • Grade 5
Goal Design Blueprint
Student Name:
Date:
Class:
1 Brainstorm Your Goal Idea
Envision, plan, and commit to achieve!
What is one positive change or skill you want to achieve for your health, happiness, or school?
Goal Timeframe
Check which kind fits:
Short-Term
Days to a few weeks
Long-Term
Several months
2 Build It with the S.M.A.R.T. Framework
Avoid traps: too general, untimely, or lacking resources!
S Specific
What exact outcome will you produce? (Who, what, and where?)
M Measure
How will you track progress and know you finished? (Number, score, or check-off)
A Achieve
Is it realistic right now? What skills, tools, or support make it possible?
R Relevant
Why does this goal matter to you? How will it help your personal life or learning?
T Timed
What is your exact target date or timeline deadline?
My Polished SMART Goal Statement
Write clearly below
Combine your answers above into one crystal-clear sentence: "I will [Specific Action] by [Target Date] so that [Meaningful Result]."
Turn over to map your action steps and overcome roadblocks! Page 1 of 2
Action Plan & Roadblock Shield
Reaching My Goal
Goal Execution Map Step-by-step to the finish line
3 Three Stepping Stones to Success
Break big goals into doable, bite-sized tasks!
Step 1: Getting Started
Target Date:
What specific action will you take first?
Resources/Materials needed:
Step 2: Building Momentum
Target Date:
What practice, routine, or check-in happens next?
Resources/Materials needed:
Step 3: Crossing the Finish Line
Target Date:
How will you complete and review your final goal?
Resources/Materials needed:
4 Roadblock Busters: Plan Ahead
Prepare for challenges before they show up!
Possible Roadblock #1
What might get in the way? (Time clash, low energy, forgetting, missing tools):
My Smart Solution:
Possible Roadblock #2
What distraction or obstacle could slow you down?:
My Smart Solution:
My Goal Supporter (Accountability Buddy)
Who can encourage you and check your progress? (Teacher, parent, or friend):
Celebration Milestone
How will you celebrate your hard work and healthy achievement?:
Personal Commitment Pledge
"I believe in my potential. I commit to taking consistent steps to reach my goal and stay physically and mentally focused."
My Signature:
Setting Positive Goals for Health and Happiness Page 2 of 2