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Home > Patients and Visitors > Form for Establishing a Routine
Use this form to problem-solve and establish a routine.
What is the problem?
What time of day or activity can be used to help you remember?
What are the steps in the routine that you need to make a habit?
What will you use to remind you to follow the routine?
We will keep track of the number of times you follow the routine by:
Plan ways to reward your child for each success. Create bonus rewards for a day in which your child remembers and completes approximately 90% to 100% of a routine.
Current as ofJune 28, 2018
Author: Healthwise StaffMedical Review: Adam Husney, MD - Family MedicineKathleen Romito, MD - Family MedicineLouis Pellegrino, MD - Developmental Pediatrics
Current as of:
June 28, 2018
Medical Review:Adam Husney, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Louis Pellegrino, MD - Developmental Pediatrics
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