The column down the left are the days of the month. Each day has three separate intensity scales. Make a note of what event you are graphing, (i.e. effectivity of medications, headaches, fatigue, etc.). Circle the intensity of what you're tracking .. 1 is for the lowest or least, 10 is for the highest or more. It's best to be consistent in the times you monitor an event since that's usually what will alert you to any continuing patterns.

This graph is tracking: ______________________________________________

          Time of Day:________ Time of Day:________ Time of Day:________

                          1 = Lowest  10 = Highest

 01        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 02        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 03        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 04        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 05        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 06        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 07        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 08        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 09        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 10        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 11        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 12        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 13        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 14        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 15        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 16        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 17        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 18        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 19        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 20        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 21        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 22        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 23        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 24        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 25        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 26        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 27        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 28        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 29        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 30        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10
 31        1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10 | 1 2 3 4 5 6 7 8 9 10

It's probably best to use this graph along with a daily journal so that you can write down what you were doing that particular day. This would allow you to go back and see what was impacting the item you were graphing. (Journaling is also a good way to keep track of your activities if you have some memory problems.

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Updated: 07/31/02