Daily Log - Medical and Goals
Log Date
*
-
Month
-
Day
Year
Date Picker Icon
Hours Slept
*
Sleep Notes (Time to Bed)
Bi-Polar Mood Questions
Impairment
Please Select
+4 Mania Severe
+3 Mania High
+2 Mania Low
+1 Mania Mild
0 Neutral
-1 Depression Mild
-2 Depression Low
-3 Depression High
-4 Depression Severe
Mood
Life Events
Symptoms
Excessive Spending
Hyper-sexual
Dysphoric Mania
Suicidal Thoughts
Other
Symptom Notes
Further Medical Notes
Blood Pressure
Blood Tests
BMI
Sexual Health (STD)
Med Change/Note
Weight
Misc./Other
Blood Pressure
Blood Tests
BMI
Sexual Health
Med Change/Note
Weight (pounds)
Scale Notes (personal/professional)
Misc Other
Goals (gamification)
Click to edit
Yes
Partial
No
Exercise? (over 30min)
Kegel Reps (1000)
Meditation
Luminosity
Anki Flash Cards
Read Book (over 30min)
Useful Research (over 20min)
Water (13 fl. Cups)
Vegetables
No Sugar
No Alcohol
No Other Substances
No Porn
PLAN tomorrow
General Nutrition
Work and Business
Categorize Your Day
*
Work Day
Non Work Day (intentional)
Non Work Day (other)
Overall, How productive was your day?
How Stressful/Frustrating Was Your Day?
Hours Worked
Non Work - Other Notes
Professional Development Activites
Networking
Seminar/Event
Learning/Research
Social/Network Notes
Event Location, Market, Focus, etc
Business Cards Handed Out?
Learning/Research Notes
Subject area, Learning type (youtube, book, blog, etc)
Did you take action on yesterdays Most Important Thing?
*
Yes - Completed
Yes - Still working Tomorrow
Yes - Stalled/On Hold/Waiting
No - Impossible (IE none set)
No - (insert excuse)
Most Important Thing Tomorrow?
*
First Thing you are working on or MUST start or complete Tomorrow
Overall Rate the Day
1
2
3
4
5
I need more Notes
General/Misc.
Secret to Success
Cause of Failure
Awesome Idea or Quote
More Notes
Submit
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