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
List All Changes Made
During the Day
Aches
Anxiety
Appetite
Body Pains
Energy
Exercise
Fatigue
Mood
Sleep