Colorado Fibromyalgia Center - Better For Life.
Daily Journal Entry
 
It is important that your daily symptoms and progress be monitored closely.  That is why we have created a simple, fast way of reporting this information to your physicians.  Please remember to submit a new form each day until your doctor instructs you otherwise.
 
Name:
Rate your overall sense of well-being today (1 being terrible, 10 being excellent):
Rate your pain level (1 being no pain, 10 being unbearable pain):
Rate your fatigue level (1 being no fatigue, 10 being terribly fatigued):
Rate your sleep last night:
Please provide any details on your symptoms/thoughts that may help form a picture of how you felt today:
Website provided by  Vistaprint
Website
provided by Vistaprint