Daily Routine Planner

This form helps you plan a balanced and sustainable daily routine.  Use the information you have gathered on the Daily or Weekly Record of Activity and consider how to improve your current activity and rest regime - then record an improved schedule on the Daily Routine Planner.  The Activity Categories form will also help when thinking how to spread High, Medium and Low activity throughout the day.   (Your routine can be adjusted when you feel ready to increase activity - or decrease in the case of a relapse.) 

One example, below, shows how you could use sticky notes to plan the days' rest and activity periods, but not necessarily the detail of what you will be doing.  If you use sticky notes you can easily adjust them as necessary. 

There are 2 examples and 2 blank templates of this form (one with 20 minute timeslots).    Blank forms are available in Word or PDF format.  Example forms are available in PDF format only.   Click on the DOWNLOAD buttons below.