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  • Break Room Sign-In

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    This document is a sign-in sheet for employees to log their breaks. It asks them to indicate their current mood by checking boxes next to emotions like happy, frustrated, or sad. It also provides a list of potential break activities for employees to choose from, such as using an elliptical machine, reading, or coloring. Employees then sign out if borrowing items like a fidget chair or yoga ball during their break.

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    break room sign-in

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    This document is a sign-in sheet for employees to log their breaks. It asks them to indicate their current mood by checking boxes next to emotions like happy, frustrated, or sad. It also provides a list of potential break activities for employees to choose from, such as using an elliptical machine, reading, or coloring. Employees then sign out if borrowing items like a fidget chair or yoga ball during their break.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Download as pdf or txt
    57 views1 page

    Break Room Sign-In

    Uploaded by

    api-362203634
    This document is a sign-in sheet for employees to log their breaks. It asks them to indicate their current mood by checking boxes next to emotions like happy, frustrated, or sad. It also provides a list of potential break activities for employees to choose from, such as using an elliptical machine, reading, or coloring. Employees then sign out if borrowing items like a fidget chair or yoga ball during their break.

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    © All Rights Reserved
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    of 1

    Break Room Sign- In

    Name​:__________________________ Date​:___________

    Check-in with how you are feeling.


    Green Yellow Red Blue

    ❏ Happy ❏ Frustrated ❏ Angry ❏ Sad


    ❏ Calm ❏ Worried ❏ Terrified ❏ Sick
    ❏ Content ❏ Nervous ❏ Upset ❏ Tired
    ❏ Focused ❏ Silly/Wiggly ❏ Enraged ❏ Bored
    ❏ Average ❏ Excited ❏ Frantic ❏ Moving Slowly
    ❏ Satisfied ❏ Anxious ❏ Grief
    ❏ Aggravated ❏ Disappointed
    ❏ Distracted ❏ Hurt
    ❏ Cranky
    ❏ Irritated
    ❏ Afraid
    ❏ Confused
    ❏ Concerned

    What are you going to do on your


    break?
    ❏ Swing
    ❏ Treadmill
    ❏ Rolling pins
    ❏ Elliptical Machine
    ❏ Exercise Bike
    ❏ Bubbles
    ❏ Read a Book
    ❏ Color/Draw
    ❏ Bean bag chair
    ❏ Lava Lamp
    ❏ Fidget Tub
    ❏ Listen to music
    ❏ Talk to an adult
    ❏ Write a letter
    ❏ Other: ____________________
    ❏ Sign-out an activity:

    ❏ Fidget Chair ❏ Yoga Ball ❏ Medicine ❏ Play-Dough


    Ball

    * Turn-in to start your break.

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