Free printable symptom diary template (PDF)

Simple one-page diaries you can print or save as a PDF – no sign-up needed. Choose a symptom and pain diary, an asthma diary or a seizure diary, each with the columns doctors find most useful.

Your free template

In the print window, choose your printer, or choose “Save as PDF” to download it. Each template prints on one A4 page, in the same style as the reports in the WellNest app.

WellNestPersonal health companion

Symptom Diary

Name:·Month:·Prepared for your healthcare provider
DateTimeIntensityLocationTypeTriggers / notesWhat helped

Intensity: 0 none · 3 noticeable · 5 hard to ignore but I can keep going · 7 stops me doing normal things · 10 worst imaginable. Type: e.g. aching, burning, stabbing, stiff, shooting.

Free template from WellNest (wellnest.services). This is a personal health log, not a medical record or diagnosis. In an emergency in Australia call 000.Page 1 of 1

How to use it

Fill in a row each time a symptom, flare, asthma episode or seizure happens, and keep your scales consistent. Add a quick row on good days too – they show your doctor the full picture. Before your appointment, summarise the month in a few lines: how many episodes, how severe on average, what seemed to trigger them and what helped. Our guide on how to keep a symptom diary your doctor will actually use has more tips, and the appointment prep checklist covers what else to bring.

Prefer an app?

Paper works if you stick with it. If you'd rather not carry a sheet around, WellNest keeps the same diaries on your phone or computer, dates every entry automatically, keeps your medications and appointments alongside them, and turns your entries into a PDF report for your doctor. It has dedicated trackers for chronic pain, CRPS, fibromyalgia, asthma and epilepsy. Try it free for 7 days.

Chris Greenfield, founder of WellNest

Chris built WellNest after years of managing his own chronic health conditions and juggling scattered notes between appointments.

FAQ

Are these diary templates free?

Yes. You can print them or save them as a PDF as many times as you like, with no sign-up.

What should I write in a symptom diary?

The date and time, what you felt and where, how severe it was on a consistent 0–10 scale, how long it lasted, what might have triggered it, and what you tried and whether it helped.

Is there a printable asthma diary?

Yes. Choose the Asthma template to record peak flow, symptoms, triggers, reliever puffs and whether you took your preventer. Always follow your written asthma action plan.

Is there a printable seizure diary?

Yes. Choose the Epilepsy template to record the date and time, seizure type, duration, warning signs, possible triggers, rescue medication and recovery.

How long should I keep a diary before seeing my doctor?

Two to four weeks of consistent entries is usually enough for patterns to show.

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