|
Chapter Seven
Daily Journal
Date: __________
Pre-Taper / Taper (Circle one) Day # _____, Step # _____
Note: Do Not Change Eating
or Exercise Habits During The Program!
Current Drugs & Dosages : (List all taken, time of day and amount)
_______________
_______________ _______________
Food and
Liquid:
(List all food and liquid consumed, time of day and amount)
The Road Back Nutritionals:
(List all taken, time of day and
amount)
Rate the
Following Areas Using a Scale of 1 to 10: (Rate
daytime anxiety at bedtime and rate the previous night's sleep first thing in
the morning. Rate all other items before bedtime.)
|
Symptom
|
1-10 Rating
|
|
Aches
|
|
|
Anxiety |
|
|
Appetite
|
|
|
Body Pains
|
|
|
Energy
|
|
|
Exercise
|
|
|
Fatigue
|
|
|
Mood
|
|
|
Sleep
|
|
|