My stay well plan
A printable from Stay Well Plan. Fill it in by hand. Nothing you write is collected by this website.
My stay well plan
1. What I worked on and what I learned
- Goals I worked toward: ______________________
- Progress I am proud of: ______________________
- Skills that helped most: ______________________
- Something my therapist said that I want to remember: ______________________
2. My daily habits (what keeps me steady)
- Sleep: I go to bed around ______ and wake up around ______
- Movement: ______________________
- Connection: ______________________
- Quiet time, prayer or reflection: ______________________
- Things I limit (news, social media, alcohol): ______________________
3. My go to tools
- When I feel worried or stressed, I can: ______________________
- When I need to calm my body, I can: ______________________
- One small thing that almost always helps: ______________________
4. My warning signs
- The first thing that changes when I start to slip: ______________________
- Other signs I notice: ______________________
- Signs other people notice in me: ______________________
5. My people
- Someone I can call any day: ______________________ Phone: ______________
- Someone who helps me get out of the house: ______________________
- What I want them to do when I am struggling: ______________________
6. My plan if things get worse
- Green (okay): I keep doing ______________________
- Yellow (slipping): I will ______________________ and tell ______________________
- If yellow lasts about 2 weeks, I call: ______________________ Phone: ______________
- Red (need help now): call or text 988. In a life threatening situation, call 911.
- My safety plan is kept: ______________________
Numbers
- My former therapist or clinic: ______________________
- My doctor: ______________________
- San Mateo County ACCESS: (800) 686-0101 / Santa Clara County Behavioral Health: (800) 704-0900
- California Peer Run Warm Line (not a crisis line): 855-600-9276
- 988 Suicide & Crisis Lifeline: call or text 988
Date I made this plan: __________ Date I will review it: __________
From Stay Well Plan. Facts checked October 21, 2026. Free information, not legal or medical advice.
