Migraine Headache Journal

If you suffer from headaches, the most useful thing for your doctor to help you diagnose it is a journal of the most recent instances. This form design was inspired by a pamphlet at a doctor's office, only this one gives you way more room to record things properly.

The form has columns to record the date, start & end time, the possible triggers, the symptoms and the treatment you tried. At the end of each page is a reminder of commons trigger sources for migraine type headaches. There is room for a lucky 13 headaches per page.

This is a classic sized page, with two pages on a single 8.5 x 11 (print and cut in half for two pages). This was created using Microsoft Excel, and printed to an Adobe PDF format.

Disclaimer: I'm not a doctor, just a lifelong headache sufferer. Use at your own risk. Take two of these and call someone else in the morning.

Paper size: 
Classic (5.5 x 8.5)
Usage advice: 

When the headache first begins, record the time. Record what it feels like (pain in the forehead, back, all over, etc.). Look at the possible triggers list and try and remember exposure to any of those items in the past 24 hours.

In the treatment column, record any pills or other techniques you used to try and alleviate the pain. When the headache ends, write down the time.

Creative Commons
Applications required: 
Adobe Acrobat, Microsoft Excel
Headaches2.pdf9.6 KB
Headaches2.xls20.5 KB
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Hate to admit it, but this is quite useful to me...

I know what you mean, this

I know what you mean, this was a form I'd like to never make,print, and use. >grin<

I'm adding this one to my

I'm adding this one to my planner right away.