Date

Schedule (what time did you do these things):

wake up

breakfast

lunch

dinner

exercise type time of day amount

cold thermogenesis time of day, amount of exposure,

type of exposure, temperature

bedtime

artificial light exposure?

EMF exposure?

Toxic chemicals exposure?

Mold exposure?

Stressful event?

Food and Drink Intake (describe briefly what you ate and approx.

quantities)

breakfast

lunch

dinner

water

snacks

supplements and medications

Sleep:

Quantity (from what time to what time?)

Quality. Did you wake up during the night? How many times?

How refreshed did you feel in the morning? 1 2 3 4 5 6 7 8 9 10