Report: Template

Date:
Day of Study:

Happiness (Mean) to Compliance (Total) Ratio:



Happiness

Score: (T/4)10=

AM:
High:
Low:
PM:


Notes:

A rating of 10 would be similar to how I felt the day we got married, or the day we went up in a hot air balloon to celebrate my birthday.

A rating of zero would be similar to how I felt after my bad break-up with R or after I found out my dad had killed him self. Zero is feeling so bad I am physically paralyzed if left alone and feel like I might die from the sheer weight of my feelings.

Suicidal feelings would rate in the negative. I don't expect to have those. (I don't expect to be in the zero's either.)

Is it even possible to be at 10 everyday? How about the high 9's? Is seems unreachable...but I'm going to stretch my imagination to believe that it might be possible.



Health
Self Report: (how healthy do I FEEL?)
Physical Comfort:
Symptoms:
Appearance:
Weight:


Compliance

Score: (T/15)100=

Food:
Exercise:
Water:
Sleep:
Hygiene:


Notes on Compliance:
Food:(1 point for only eating food on the plan. 1 point for proper calorie intake. 1 point for proper distribution.)
Exercise: (1 point for getting dressed and going out. 1 point for full 30 min cardio. 1 point for full 30 min yoga.)
Sleep:(1 point for getting up early, between 5 and 6. 1 point for going to bed early then night before, between 9 and 10. 1 point for getting at least 8 hours...with a nap or without.)
Water:(1 point each for 32 oz container finished. At least one is plain. One can be flavored with lemon, lime, and/or cayenne. One can be herbal tea.)
Hygiene:(1 point for skin care; sunblock and nightly scrubbing. 1 point for flossing. 1 point for brushing after every meal)

Total possible = 15

Notes on Scoring:
Health score is total divided by 4, times 10. (T/4)10
Compliance score is total divided by 15, times 100. (T/15)100