Please be aware there is no way of saving this form part way through with the intent of continuing later. In other words, you need to complete this form in one sitting, one session.
Your full name:
Please check all those that apply to you.
WHEN: I smoked when I was feeling...
WHERE: I smoked a lot....
WHY: I smoked whenever I needed...
Unique trigger (if any) not listed above.
NEW BEHAVIOURS
NEW BEHAVIOURS MASTER LIST: 1) I will breathe deeply, 2) I will close my eyes, 3) I will smile, 4) enter below, 5) enter below, 6) enter below.
Enter your 4th new behaviour here. "I will..."
Enter your 5th new behaviour here. "I will..."
Enter your 6th new behaviour here. "I will..."
Remember to handwrite all of your new behaviours for each of your triggers as shown in your kit. *** Important: bring your handwritten notes with you at your next session.
Your comments or questions here. Or, if you prefer, email or call me.