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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.)
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Symptom
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1-10 Rating
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List All Changes Made During the Day
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Aches
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Anxiety |
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Appetite
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Body Pains
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Energy
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Exercise
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Fatigue
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Mood
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Sleep
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