Daily Anxiety Routine Checklist
Track your daily routines, coping strategies, and progress in managing anxiety.
Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
How would you rate your anxiety level today?
*
Very Low
1
2
3
4
5
6
7
8
9
Very High
10
1 is Very Low, 10 is Very High
Which of the following coping strategies did you use today? (Select all that apply)
*
Deep breathing exercises
Mindfulness/meditation
Physical activity/exercise
Talking to someone
Journaling
Listening to music
Other
How would you describe your overall mood today?
*
Please Select
Calm
Anxious
Irritable
Sad
Happy
Neutral
Other
Did you notice any specific triggers or situations that increased your anxiety today?
How well did you sleep last night?
Very well
Well
Average
Poorly
Additional notes or reflections
Submit Checklist
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