• FirstLine Therapy Food & Lifestyle Journal

  • Please complete and submit one of these “Food & Lifestyle Journal” every day for 7 days.

    1. Make note of the time you wake up.

    2. List and describe in detail all foods and drinks, including the amount of each. Make note as to whether the food was fresh, frozen, canned, raw, cooked, baked, fried, etc. Note the time of each meal or snack. Be sure to list everything, including each amount you eat or drink, including any condiments used (e.g., mayonnaise, mustard, relish).

    3. Keep track of how much water you drink and list the amount in ounces (or ml or l) in the section provided. Also note the type and amount of any other drinks you consume.

    4. Write down any activity or exercise you do, listing the kind of exercise you did and for how long you did it.

    5. Note any periods of relaxation and what kind of relaxation it was.

    6. Note the time you go to sleep.

  • TODAY’S JOURNAL

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