When this sheet can help
If you prefer a notebook or want to start without an app, print this A4 sheet. Its seven rows are for seven observations, including several on the same day. Print another sheet when you need more space.
To share your Reliefly journal
This sheet is not an export. In Reliefly, open Settings, then Prepare a consultation to review the free summary of the last seven days. Full PDF reports and CSV exports are available with Plus.
Your personal scale
Use a 0–10 scale consistently, with 0 for no pain. A pain-free day can be explicitly recorded. This template supports personal tracking and does not replace medical advice.
How to fill in the sheet
One row is one observation: add a date, time, intensity and body area. Context is optional. The seven rows do not require one observation a day. Print more sheets when needed and explicitly write “pain-free” rather than leave a cell blank.
Keeping or sharing your sheet
You control the completed sheet. Store it where you choose and select what to show during a conversation. The website does not receive what you write on paper. For a digital copy of your Reliefly journal, use the app’s PDF features.
My pain journal
| Date / time | Intensity 0–10 | Area | Notes / context |
|---|---|---|---|
My questions for the appointment
Your journal, on your phone.
Log pain and revisit your history in Reliefly, without creating an account.
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