Halloform
Coaching

Habit-Change Readiness Assessment form template

Based on the stages-of-change model, this scores whether you're contemplating, preparing or acting on a new habit. A confidence follow-up appears for the hesitant, and jumps route to Awareness, Preparation or Action support with a first micro-step.

CoachingHabitsSelf-report
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What’s in the box

Stage scored

Your answers place you on the stages-of-change ladder.

Confidence check

A follow-up appears when self-belief looks shaky.

Micro-step

Each stage ends with one tiny action to take today.

Perfect for

  • Health coaches
  • Therapists
  • Wellness apps
  • Self-improvement

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