Situation / Environmental Notes:
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Spontaneous ____ or Planned ____
Why did I choose this act?
How do I feel physically BEFORE? __________________________________________________
How do I feel emotionally BEFORE?_________________________________________________
How do I feel physically DURING? __________________________________________________
How do I feel emotionally DURING? ________________________________________________
How do I feel physically AFTER? ____________________________________________________
How do I feel emotionally AFTER? __________________________________________________
How is this experience NEW or Different?
How is it relevant to me? My goals? My values? Who I would like to be as a person?
Did I spend 20-30 seconds intentionally staying with the thoughts, physical, and emotional experiences produced to install them? Yes / No
RAK #2:
Situation / Environmental Notes:
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Spontaneous ____ or Planned ____
Why did I choose this act?
How do I feel physically BEFORE? __________________________________________________
How do I feel emotionally BEFORE?_________________________________________________
How do I feel physically DURING? __________________________________________________
How do I feel emotionally DURING? ________________________________________________
How do I feel physically AFTER? ____________________________________________________
How do I feel emotionally AFTER? __________________________________________________
How is this experience NEW or Different?
How is it relevant to me? My goals? My values? Who I would like to be as a person?
Did I spend 20-30 seconds intentionally staying with the thoughts, physical, and emotional experiences produced to install them? Yes / No
RAK #3:
Situation / Environmental Notes:
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Spontaneous ____ or Planned ____
Why did I choose this act?
How do I feel physically BEFORE? __________________________________________________
How do I feel emotionally BEFORE?_________________________________________________
How do I feel physically DURING? __________________________________________________
How do I feel emotionally DURING? ________________________________________________
How do I feel physically AFTER? ____________________________________________________
How do I feel emotionally AFTER? __________________________________________________
How is this experience NEW or Different?
How is it relevant to me? My goals? My values? Who I would like to be as a person?
Did I spend 20-30 seconds intentionally staying with the thoughts, physical, and emotional experiences produced to install them? Yes / No
Mariafrm2002
RandomActsofKindness-FieldNotes-1.docx
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