ACTIVITY TRACKER

Date:

Time:

Activity:

May 1 (8:30 am) - Got dressed and had some difficulty looking down to fasten up the buttons on my shirt.

May 1 (1:45 pm) - Spoke with a friend on the phone for about 10 minutes, had to get off the phone because my arm went numb holding up the phone.

May 2 (4:30 pm) - Walked the dog for about 10 minutes.

May 2 (9:00 pm) - Read a book for 5 minutes, needed to rest my arms and head for 10 minutes but then was able to read for another 20 minutes.

Make sure you write down what you have trouble with but also, don’t forget to include those activities you are able to do. Both of these provide the doctor with valuable information that helps to provide an accurate diagnosis.