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Exercise Planning Form

Overview

No matter what your exercise goal is, making a specific plan can help you be more successful.

Follow these steps to create your plan. Then bring this sheet when you visit your doctor so you can refine your plan together. You may also want a personal trainer or fitness expert who can help you with your exercise goals.

Step 1: Know why you want an exercise goal.

Why is this goal important to you? Make sure it's what you really want to do and like to do.



Step 2: Set a specific long-term exercise goal.

What is a long-term goal that you can reach in about 6 to 12 months?



Step 3: Set your short-term goals.

How can you create short-term goals that you take week by week to reach your long-term goal?



Step 4: Prepare for slip-ups or setbacks.

What might get in the way of your reaching this goal? You may already know that things like time, money, or not liking exercise could get in the way. How might you get around these?



Step 5: Plan for support and rewards.

Who can help you meet your goals? Maybe friends, family, or a walking buddy? And how will you reward yourself? A movie, a special meal, or an hour to yourself can be a treat.



Step 6: Review With My Doctor

Questions to ask my doctor

  • Any health problems I need to keep in mind?
  • Any special tests I need before I start an exercise program?
  • Any exercises I need to avoid?
  • What exercises are safe for me that I know I'll enjoy?
    • Aerobic exercises: How often and how long
    • Flexibility exercises: How often and how long
    • Strength and balance exercises: How often and how long
  • Any warning signs I need to watch for?
  • Should I take my pulse when I exercise? If so, what range is best for me (target heart rate)?
  • Should I change the time I take my medicines?
  • Other questions

See your success!

Creating this exercise plan is your first step to success. Post it in a place where you'll see it, and revisit it as you meet your goals. Nice work!

Related Information

Credits

Current as of: July 31, 2024

Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Current as of: July 31, 2024

Author: Ignite Healthwise, LLC Staff

Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Dear patient

I am excited to announce that I will be relocating my practice to Houston Methodist DeBakey Cardiology Associates. Starting November 4, 2024, my new address will be:

Houston Methodist DeBakey Cardiology Associates
6550 Fannin St.
Smith Tower, Suite 1901
Houston, TX 77030

Please note that my phone number and fax number will also change to the following:
24-Hour Telephone: 713-441-1100
Fax: 713-790-2643
Clinical Support Telephone (M-F, 8-5): 713-441-3515

I am excited about caring for you in my new office and hope you will make the transition with me. I will also continue to refill your medications as I have in the past. To assist, please provide your pharmacy with my new contact information.

Please consider checking your prescription refills to verify that you have enough medication on hand to last you until your next visit. Please note that your medical records will remain at my former office until you authorize their transfer. If you choose for me to continue providing your medical care, please complete and sign the enclosed “Authorization for Release of Medical Records” form and fax it to 713-790-2643. Once we receive your authorization, we will be happy to process the request for you.

Thank you for entrusting me with your medical care. My new team and I are dedicated to making this transition as seamless as possible. For help scheduling an appointment and transitioning your care, please call my new office number above.

I look forward to continuing your care at my new location.

Sincerely,
Gopi A. Shah, MD

Dear patient

Dr. Albert Raizner, Dr. Michael Raizner, and Dr. Mohamed El-Beheary are excited to announce that our practice, Houston Cardiovascular Associates, will merge with Houston Cardiovascular Associates on November 1, 2024.

Our new offices are similarly located in Houston, near the Texas Medical Center and in Sugar Land. Our in-hospital care will continue at Houston Methodist Hospital in the Texas Medical Center and Houston Methodist Sugar Land Hospital. Importantly, our new offices expand our services with state-of-the-art equipment and amenities. Our core values will always be, as they began over 40 years ago when Dr. Albert Raizner founded HCA:

Integrity – Compassion – Accountability

Our new address and contact information are:

Your medical records are confidential and remain available at our new locations. We consider it a privilege to serve as your cardiologists and look forward to your continuing with us. However, should you desire to transfer to another physician, you may request a copy of your records by contacting us at our new addresses and phone numbers listed above.

We thank you for your trust and loyalty. As always, we will continue to be here to take care of you. Please do not hesitate to contact us if you have any questions or concerns.

Sincerely,

Dr. Albert Raizner,
Dr. Michael Raizner,
Dr. Mohamed El-Beheary