Daily Symptoms Tracker
Take an active and effective role in your own personal health by tracking your symptoms and their intensity. Having a record of your symptoms ensures your doctor has an accurate set of data to provide you the best care.
Take an active and effective role in your own personal health by tracking your symptoms and their intensity. Having a record of your symptoms ensures your doctor has an accurate set of data to provide you the best care.
Take an active and effective role in your own personal health by tracking your symptoms and their intensity. Having a record of your symptoms ensures your doctor has an accurate set of data to provide you the best care.
Symptom:
List what you are experiencing.
Time of Day:
Morning: 5 A.M. - 12 P.M.
Afternoon: 12 P.M. - 5 P.M.
Evening: 5 P.M. - 9 P.M.
Night: 9 P.M. - 5 A.M.
Severity:
1 - Minimal; pain is hardly noticeable
2 - Mild; notice pain, but does not interfere with activities
3 - Uncomfortable; pain is sometimes distracting
4 - Moderate; pain is distracting, but can still do normal activities
5 - Distracting; pain interrupts some activities
6 - Distressing; pain is hard to ignore and avoiding usual activities
7 - Unmanageable; cannot focus because of pain, pain prevents doing daily activities
8 - Intense; pain is awful, unable to do anything
9 - Severe; pain is unbearable, unable to do anything
10 - Unable to Move; pain is as bad as it could be
Was Medication Taken to Mitigate Symptom:
Did you take a painkiller or other medication to alleviate the symptom? If you did, what did you take and how much?
Notes:
Any additional notes you might have such as how long your symptoms lasted throughout the day or potential cause.