Personal Fatigue Diary
A month-by-month record to track your fatigue level.
Use this easy-to-follow monthly guide to chart your own daily fatigue level. Here's how:
1. Select the month of the year and print out the blank form.
2. Post it in a convenient place, such as the refrigerator.
3. Mark your daily fatigue level by coloring in the circle that corresponds to how you are feeling each day (see key code at bottom of form).
4. At the end of each month, draw a line connecting the colored-in circles; you will begin to see how your fatigue level has changed over time.
5. Take the form to your next office visit and use it as a guide to discuss how you've been feeling.
You'll also find space to record these other important test results each week:
These files are saved in Adobe's Portable Document Format (PDF). In order to view these online as well as print them out you will need to have the Adobe Acrobat Plug-In. Download Acrobat Reader.
- Hb level
- RBC count
- Blood pressure
Click on a month to download it in PDF format: