Free symptom diary template (printable PDF)
This template is one page with twelve rows. Print it, keep it somewhere you will see it, and fill in a row when something happens or changes.
Download the symptom diary template (PDF, one page)
The columns
Each column answers a question that intake forms often ask:
- Date of this note
- What I noticed, and where
- How strong, 0 to 10
- When it started, if different, or "not sure"
- What was going on around then
- What I want to ask
Why two dates
The date you write a row and the day it began are often different. The first note you have shows when you first wrote it down, not necessarily when it started, so the template keeps them separate.
How to use it
Fill in a row on the day, even a short one. Quiet days can stay blank. When a page fills up, start a new one and keep the old pages together.
Before your appointment
Circle the rows you want to talk about and bring the page with you.
- What changed:
- When I first noticed it:
- What I want to ask:
To put your notes on one printable page, use the free visit summary.
Related guidance: NHS: preparing for an appointment
Keep dated notes in Ever Since
A symptom entry can include where it is, how strong it feels, and your own words. Each entry keeps the date it was logged. Symptom logging is included in the free plan.
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