Personalized Wellness Action Plan (Nutrition, Lifestyle, and Supplements)

(Write directly to the patient using plain language, active voice, and clear instructions. Avoid abbreviations, jargon, and unexplained medical terms. Keep paragraphs short and use bullet points for scannability. Omit sections that were not discussed. Do not infer motivation or diagnoses. If details are unknown, note the gap and state the next step.)

Patient Name: [Patient name]

Date: [Date of plan]

Clinician: [Clinician name and credentials]

Contact: [Phone or portal for questions; urgent line if applicable]

Your Top Priorities

Main Message: [1–3 sentence summary of what matters most from today, reflecting the patient's stated priority and the clinical rationale in plain language]

Top Priorities:

(List 1–3 items. For each priority, include what to do, when to start, how often, and how you'll know it's working. If only one priority, use singular heading "Top Priority".)

1. [Priority 1 short title]

   • What to do: [Specific action steps in simple language]
   • When to start: [Start date / today / tomorrow]
   • How often: [Frequency and timing]
   • How you'll know it's working: [Simple signs, symptoms, or numbers to look for]

2. [Priority 2 short title] (Include only if applicable.)

   • What to do: [Action steps]
   • When to start: [Start timing]
   • How often: [Frequency]
   • How you'll know it's working: [Indicators of progress]

3. [Priority 3 short title] (Include only if applicable.)

   • What to do: [Action steps]
   • When to start: [Start timing]
   • How often: [Frequency]
   • How you'll know it's working: [Indicators of progress]

Start Here (This Week):

(List 2–4 simple actions for the next 7 days.)

• [Immediate action 1]
• [Immediate action 2]
• [Immediate action 3] (Include only if applicable.)
• [Immediate action 4] (Include only if applicable.)

Your Goals: [Patient-stated outcomes in their own words; include key barriers discussed and supports planned] (Omit if goals were not explicitly assessed.)

Nutrition

(Include only if nutrition was discussed. Keep brief and actionable.)

• Recommended eating approach: [Plain-language description of dietary pattern]
• Focus on: [Foods or behaviors to have more of]
• Limit: [Foods or behaviors to reduce]
• Swap ideas: [Simple substitutions the patient can try] (Include only if discussed.)
• Targets: [Specific targets with patient-friendly translation, e.g., "30g protein per meal—about a palm-sized portion"] (Include only if specific targets were set.)
• Referrals: [Nutrition referral or program and how to access] (Include only if applicable.)

Lifestyle

(Include only the areas discussed. Omit subsections not addressed. If a major area was deferred, note it will be covered at a future visit.)

• Movement: [Weekly plan with minutes, days, and types of activity; include pacing and any safety limits] (Include only if discussed.)
• Sleep: [Sleep goal and 1–3 routine changes to try] (Include only if discussed.)
• Stress management: [Simple techniques, when to practice, and duration] (Include only if discussed.)
• Other behaviors: [Tobacco, alcohol, screen time, social connection, or other habit changes] (Include only if discussed.)
• Deferred: [Area to address at next visit] (Include only if a major area was explicitly deferred.)

Supplements & Medications

(Include only if supplements or medications are part of the plan. Omit entire section if none apply.)

Item	Purpose	Dose/Form	When/How to Take	Duration	Key Cautions
[Start / Change / Stop / Continue]: [Item name]	[Why you are taking it]	[Dose and form]	[Timing and instructions]	[How long to take it or until next review]	[Allergy, interaction, pregnancy, surgery, or other cautions]
[Start / Change / Stop / Continue]: [Item name] (Add additional rows as needed.)	[Purpose]	[Dose/Form]	[When/How]	[Duration]	[Key cautions]

Safety reminders:

• Tell all your doctors and pharmacists about these supplements and medications.
• If you have surgery or a procedure planned, ask whether you need to stop any items and when.
• If any dose or frequency is unknown, do not increase the amount. Please send a clear photo of the product label so we can confirm the plan. (Include only if details are missing.)

Monitoring & Next Steps

Track:

(List key metrics to track with frequency and target. If no objective metrics were chosen, use simple symptom tracking.)

• [What to track] — [How often] — [Target or what improvement looks like]
• [Additional metric to track] — [Frequency] — [Target] (Include additional items only if applicable.)

Labs/Tests: (Include only if tests were ordered.)

• [Test name] — [Timing/window]; [Fasting or preparation instructions] — [How and when results will be shared]

Follow-Up:

• [When to return and visit format] — [Purpose of the next visit] — [What to complete beforehand]

Contact Us Sooner If:

• [Specific symptoms, side effects, or concerns that should prompt earlier contact]

Resources: (Include only if resources were provided.)

• [Trusted resource or link]
• [Additional resource] (Include only if applicable.)