Appendix IV. Worksheet
Fear Action Plan
Three Fears I Have Since My Loved One Died:
1.
2.
3.
Things I Can Do To Be Less Afraid:
| Fear #1: | What I Can Do: |
| Fear #2: | What I Can Do: |
| Fear #3: | What I Can Do: |
What We Can Do To Make Our Lives Safer?
1. Goal: _______________________________________________
Action Steps to Accomplish Goal:
a. _________________________
b. _________________________
c. _________________________
d. _________________________
e. _________________________
2. Goal: _______________________________________________
Action Steps to Accomplish Goal:
a. _________________________
b. _________________________
c. _________________________
d. _________________________
e. _________________________
3. Goal: _______________________________________________
Action Steps to Accomplish Goal:
a. _________________________
b. _________________________
c. _________________________
d. _________________________
e. _________________________