TLC check in

Complete the form below to submit your check-in for the week.

Check-ins are due by Wednesday at midnight.

Name

First Name

Last Name

Today I'm feeling:

I'm feeling this way because:

Something I can do to make myself feel 2% better is:

My primary focus for this week is:

(One bite sized action step towards your larger goals)

A challenge associated with this that I am experiencing/anticipating is:

A way I might overcome this is:

3 things I'm grateful for:

I'm proud of myself for:

One self care thing I will do this week for me and no one else: