Date: __________________

How are you feeling about your body today?

On a scale of 1 to 10 where 1 is really bad and 10 is outstanding/amazing

How many hours of sleep you got last night

How was your sleep? Any observations?

Please list everything that you

ate and drank before noon today

How did you feel afterwards?

What observations did you make about

the decisions?

Please list everything that you ate or

drink in the morning today?

How did you feel afterwards?

What observations did you make about

the decisions?

B/903, Samudra Complex, Near Girish Cold Drinks, Off C G Road, Ahmedabad – 380 009
Mail – mithileshchudgar@gmail.com, phone: +91 9327114164
Please list everything that you ate or

drank in the middle of the day

today?

How did you feel afterwards?

What observations did you make about

the decisions?

Please list everything that you ate or

drank in the late afternoon and

evening today?

How did you feel afterwards?

What observations did you make about

the decisions?

Please list everything that you ate or

drank in the late evening or

overnight?

Please list any physical activity,

Workout or exercise you did today?

Howdid you feel afterwards?

What observations did you make about

the decisions?

B/903, Samudra Complex, Near Girish Cold Drinks, Off C G Road, Ahmedabad – 380 009
Mail – mithileshchudgar@gmail.com, phone: +91 9327114164