Stages Of Change Assessment

Assessment:
[select name="stage" value="Precontemplation|Contemplation|Preparation|Action|Maintenance|Relapse"]
[conditional field="stage" condition="(stage).is('Precontemplation')"]No intention to change now or in the near future.  May not accept and/or be aware that there's a problem.[/conditional][conditional field="stage" condition="(stage).is('Contemplation')"]Thinking about changing but has not made a commitment to take action.[/conditional][conditional field="stage" condition="(stage).is('Preparation')"]Intends to take action in the next month.  May have made some small changes.[/conditional][conditional field="stage" condition="(stage).is('Action')"]Making change - modifying behavior, experiences, and/or the environment.[/conditional][conditional field="stage" condition="(stage).is('Maintenance')"]Working to prevent relapse and consolidate gains.[/conditional][conditional field="stage" condition="(stage).is('Relapse')"]Regression to an earlier stage.[/conditional]
Plan:       
[comment memo="Counseling techniques to move from one stage to the next (no skipping steps)"]
[checkbox value="Pros and cons worksheet" memo=" for quitting and continuing the behavior"] [text]
[checkbox value="Bibliotherapy" memo=" recommending books for self-help"] [text]
[checkbox value="Values clarification" memo=" brainstorming, collecting, and prioritizing values, then determining how to achieve success towards those values"] [text]
[text size=80]
[checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"]
reference:  
[link url="//www.ncbi.nlm.nih.gov/pubmed/6863699" memo="#1"] Prochaska JO, DiClemente CC.J Consult Clin Psychol. 1983 Jun;51(3):390-5. Stages and processes of self-change of smoking: toward an integrative model of change.
[/conditional]