Free printable
A free symptom diary template you can print and fill in by hand.
Updated: 9 October 2026
Not everyone wants another app. Some people think better on paper, some are keeping a record on behalf of someone else, and some are on an Android phone, so there's nothing to install in the first place. This is a symptom diary you can print at home: one week to a page, six columns, and room enough to write in at two in the morning.
No sign-up. Print it, or download it as a PDF. To print, press Ctrl and P, or Command and P on a Mac, and only the sheet below goes on the paper. Everything else, including this paragraph, is left off it.
How to use it
- Print one sheet a week. There are seven rows and a date column, so any week of any month works.
- Fill it in once a day, at a time you'll remember. The end of the evening suits most people, while the day is still fresh.
- Write short phrases rather than sentences. Legs heavy from lunchtime, 7 out of 10 is far more use in three weeks than bad day.
- Leave a row blank if you missed a day. A gap is information too, and it's more honest than filling it in from memory a week later.
- Keep the sheets in order. Two or three of them side by side is what turns a week into a pattern you can point at.
Weekly symptom diary
Week beginning
| Date | The day overall, 1 to 5 | Symptoms, and how bad out of 10 | What it stopped me doing | Medicines, and anything else I tried | Sleep, and anything that stood out |
|---|---|---|---|---|---|
Before my next appointment, the three things I would hate to forget
My own record of my own days, written by me. It is not a medical record, it has not been checked by a clinician, and it is not medical advice.
taluvu.co.uk · Free printable
Printing these sheets for other people
You're welcome to print or photocopy these sheets and hand them out on paper, as many copies as you need, and you don't have to ask us first. That includes support groups, charity volunteers, ward and clinic staff, libraries, schools, and anyone helping someone else keep a record. There's nothing to pay and nothing to sign.
What to put in each column
- Date. The date, and the day of the week if that helps you see the working week against the weekend.
- The day overall, 1 to 5. One number for the whole day, where 1 is a good day for you and 5 is one of your worst. Your own scale, used the same way every day, is the part that makes the weeks comparable.
- Symptoms, and how bad out of 10. Name the symptom, where it was, and a number. Two or three is plenty. The ones you would mention to a doctor are the ones worth the ink.
- What it stopped me doing. The column clinicians tend to read first. Missed work, the stairs, a shower, cooking, a plan cancelled.
- Medicines, and anything else I tried. What you took and roughly when, plus heat, rest, a dark room, anything. Note whether it made a difference, in your own words.
- Sleep, and anything that stood out. Roughly how long you slept, and one thing about the day: a late night, a long journey, a stressful morning, your period, the weather. Put it down and leave the cause an open question.
Taking it to an appointment
Appointments are short, and a sheet of paper in your hand is easier than a memory under pressure. Before you go, read your sheets through once and pick out the three things you most want to say. There's a line for them at the foot of every sheet.
Two guides carry on from here: how to prepare for a GP appointment covers what to gather and what to ask before you leave, and how to describe symptoms clearly has plain words and example lines you can borrow. If you would rather see what a longer written summary looks like, there is an example summary for a doctor.
Where paper is the wrong tool
Paper has real limits and it's fairer to say so. It can't count for you, so if you want to know how many of the last thirty days had a headache in them, you'll be adding them up yourself. It stays where you left it, it doesn't survive a cup of tea, and a filled-in sheet is health information on a kitchen table rather than something locked on a phone. If you're recording for a long stretch, or you want the counting done, an app does that part better. If you would rather nothing about you sat on a server, paper wins outright.
Questions people ask
Is this printable symptom diary free?
Yes. There's no sign-up and no email address to hand over. Print it as many times as you like, or press Download as PDF near the top of this page for the blank sheet as an A4 PDF. On an iPhone you can save it to Files or send it by email from the share sheet.
What paper size does it print on?
It's set for A4 portrait, one week to a page. It prints on US Letter as well, with a little more space at the foot of the page. Everything except the sheet itself is left off the paper.
Do I need the taluvu app to use it?
No. The sheet works on its own and it doesn't know whether you use an app or not. taluvu is an iPhone app, so if you're on Android or you would simply rather write by hand, the printed sheet is the version for you.
How many weeks should I fill in before an appointment?
There's no right number. One sheet means you can describe a week in specifics rather than from memory, and many people bring the two or three weeks before an appointment. A record with gaps in it is still a record.
Where to go next
Keeping the record without the writing
taluvu is an iPhone app for recording how the days actually go, in about a minute a day, and turning that into something you can take to an appointment. It's on the App Store as taluvu Chronic Illness Tracker.
About this page: Written by the people who build taluvu and published on 24 September 2026. It has not been medically reviewed and is not medical advice. How we write and check these pages.
Nothing on this page is medical advice. If you are worried about your health, contact your GP practice or NHS 111. In an emergency ring 999, and if you are struggling to keep yourself safe, Samaritans are on 116 123.