Diary of Symptoms

Diary of Symptoms

Topic Overview

You can help your doctor diagnose and treat your condition by being prepared to answer questions about your symptoms. Since some symptoms are difficult to describe, it is helpful to write down information about your symptoms as you experience them during your daily activities.

While waiting for your appointment, keep a diary of your symptoms. This form may help.

Describe the symptom for which you are keeping this diary:

Day

1

2

3

4

5

6

7

Time of day the symptom starts


           

Time of day the symptom bothers you the most


           

Does the symptom come and go during the day?


           

Is the symptom affected by any of the following:

  • Activity
  • Rest
  • Stress
  • Recent changes in your eating patterns, such as skipping meals
  • Prescription or over-the-counter medicines (name of medicine and time of day it affects your symptom)
  • Alcohol or caffeinated drinks (number and time)
  • Smoking or the use of other tobacco products
             

What other symptoms do you have:



           

Rate how you felt today:

1 - Great

2 - Okay

3 - Not good

4 - Bad



           

Other information about your symptom:



           

Credits

Current as of: February 11, 2021

Author: Healthwise Staff
Medical Review: Anne C. Poinier MD - Internal Medicine
Adam Husney MD - Family Medicine

Disclaimer: The information contained in this website, and its associated websites, is provided as a benefit to the local community, and the Internet community in general; it does not constitute medical advice. We try to provide quality information, but we make no claims, promises or guarantees about the accuracy, completeness, or adequacy of the information contained in or linked to this website and its associated sites. As medical advice must be tailored to the specific circumstances of each patient and healthcare is constantly changing, nothing provided herein should be used as a substitute for the advice of a competent physician. Furthermore, in providing this service, Adventist HealthCare does not condone or support all of the content covered in this site. As an Adventist health care organization, Adventist HealthCare acts in accordance with the ethical and religious directives for Adventist health care services.

Find a Doctor

Find an Adventist HealthCare affiliated doctor by calling our FREE physician referral service at 800-642-0101 or by searching our online physician directory.

View Doctors

Set Your Location

Setting your location helps us to show you nearby providers and locations based on your healthcare needs.