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---- Journal ---Time What I ate Quantity/Points With Whom

Date:
Mood Other Time

---- Journal ---What I ate Quantity/Points With Whom

Date:
Mood Other

Morning

Morning

Snack

Snack

Afternoon

Afternoon

Snack

Snack

Evening

Evening

Weekly Weigh-in Weight: Monthly Measurements:


Time

Waist:

Goal weight for next weigh-in: Hips:


For Today: Duration THR/Intensity

Upper Arms:
Comment:

Weekly Weigh-in Weight: Monthly Measurements:


Time

Waist:

Goal weight for next weigh-in: Hips:


For Today: Duration THR/Intensity

Upper Arms:
Comment:

Amount of Exercise planned for this week: Type of exercise

Amount of Exercise planned for this week: Type of exercise

Water check off (each check equals one eight-ounce glass): Took my vitamins(s): Fruit check (Aim for at least 2 fruits, 1 serving = 1 piece or a 4-6 oz. glass of juice.): Vegetables check (Aim for at least 4 servings. 1 serving = 1 cup raw or 1/2 cup cooked.): Followed food plan: 1 2 3 4 5

1 7 Yes 1 5 1 5 Yes

2 8 no 2 6 2 6 no

3 9

4 10

5 11

Water check off (each check equals one eight-ounce glass): Took my vitamins(s):

1 7 Yes 1 5 1 5 Yes

2 8 no 2 6 2 6 no

3 9

4 10

5 11

3 7 3 7

4 8 4

Fruit check (Aim for at least 2 fruits, 1 serving = 1 piece or a 4-6 oz. glass of juice.): Vegetables check (Aim for at least 4 servings. 1 serving = 1 cup raw or 1/2 cup cooked.): Followed food plan:
Done?

3 7 3 7

4 8 4

Goals/Personal Notes for Today

Goals/Personal Notes for Today

Done?

1 2 3 4 5 Reasons why I did not follow plan today (if applicable):

Reasons why I did not follow plan today (if applicable):

Positive Statements(s) about myself:

Positive Statements(s) about myself:

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