Facial Habit Awareness Tracker
Use this form to increase your awareness of facial habits, identify triggers, and reflect on your progress.
Full Name
*
First Name
Last Name
Date of Entry
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Which facial habits did you notice today?
*
Touching face (e.g., resting chin on hand)
Biting lips or inside of mouth
Clenching jaw or grinding teeth
Frowning or furrowing brows
Cheek sucking or chewing
Other
How frequently did you notice these habits today?
*
Not at all
Once or twice
Several times
Frequently throughout the day
Where were you when you noticed these habits?
At home
At work or school
In public places
While using electronic devices
Other
What emotions or triggers were present when you noticed the habit?
Stress or anxiety
Boredom
Fatigue
Concentration
Other
What actions did you take (or plan to take) to reduce or manage these habits?
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