DAILY ROUTINE

WAKE TIME:

BREAKFAST:

MORNING ACTIVITY:

LUNCH:

AFTERNOON ACTIVITY:

DINNER:

EVENING ACTIVITY:

SNACKS:

BODY

WEIGHT:

HOURS SLEPT:

WATER:

FOOD:

DRUGS

PRESCRIPTION:

CANNA:

SUGAR:

CAFFEEINE:

ALCOHOL:

NICOTINE:

OTHER:

MOOD CYCLES

MOOD SCALE (1-10):

ANXIETY SCALE (1-10):

IRRITABLITY (1-10):