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Headache Diary: Monthly Headache Calendar
After each headache you experience, use your monthly headache calendar to record the date and time of day of each headache, if medication is used, as well as the onset of a menstrual cycle. To most effectively track your headaches, this calendar should be used in conjunction with your headache details chart.
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31 |
Morning |
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Afternoon |
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Evening |
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Sleep time |
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Severity * |
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Symtoms § |
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Disability ф |
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Medication Taken |
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Menstual Peiod |
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| Month: |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
11 |
12 |
13 |
14 |
15 |
16 |
17 |
18 |
19 |
20 |
21 |
22 |
23 |
24 |
25 |
26 |
27 |
28 |
29 |
30 |
31 |
Morning |
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Afternoon |
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Evening |
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Sleep time |
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Severity * |
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Symtoms § |
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Disability ф |
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Medication Taken |
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Menstual Peiod |
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* Severity: 1 = Mild 2 = Moderate 3 = Severe .jpeg.jpeg)
§ Symptoms: 0 = None 1 = Nausea 2 = Vomiting 3 = Light Sensitivity 4 = Sound Sensitivity 5 = Aura
ф Disability: Rate 0 (none) – 10 (severe) A = Missed Work/School/Social Activity B = Emergency Room/Urgent Care Visit
Downloadable PDF |
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©2007 The Headache Wellness Center
This site is protected by copyright and trademark laws under U.S. and international law.
All rights reserved.
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