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Name: Date:
How is your mood before breakfast:
Breakfast Include
everything you eat/drink and the time. The
more information the better.
Was breakfast satisfying?
Did you need a snack?
Did you have any food cravings?
How is your mood?
How is your energy?
How is your mental clarity?
Lunch
Include everything you eat/drink and the
time. The more information the better.
Was lunch satisfying?
Did you need a snack?
Did you have any food cravings?
How is your mood?
How is your energy?
How is your mental clarity?
Dinner Include
everything you eat/drink and the time. The
more information the better.
Was dinner satisfying?
Did you need a snack before bed?
Did you have any food cravings?
How is your mood?
How is your mental clarity?
Did you have a bowel movement?
If so, what time of day?
What is your overall assessment of how you felt today?
How much water did you drink today?
Daily Inventory
Please complete one for at least 3 typical work days and 2 typical weekend days.
Before lunch answer the following:
Before dinner answer the following:
Before bed answer the following: