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 |
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Time of day the symptom starts |
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Time of day the symptom bothers you the most |
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Does the symptom come and go during the day? |
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Is the symptom affected by any of the following:
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What other symptoms do you have: |
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Rate how you felt today: 1 - Great 2 - Okay 3 - Not good 4 - Bad |
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Other information about your symptom: |
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Current as of: October 6, 2021
Author: Healthwise Staff
Medical Review:Anne C. Poinier MD - Internal Medicine & Adam Husney MD - Family Medicine
This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.
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