Social Media Cessation Log Form
Track your journey to reduce or stop social media usage. Log your progress, challenges, and strategies to support your goals.
Full Name
*
First Name
Last Name
Date of Log Entry
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Which social media platforms are you trying to reduce or quit?
*
Facebook
Instagram
Twitter/X
TikTok
Snapchat
LinkedIn
Other
How much time did you spend on social media today?
*
None
Less than 30 minutes
30-60 minutes
1-2 hours
More than 2 hours
What triggered your urge to use social media today?
Boredom
Loneliness
Stress/Anxiety
Habit
Notifications
Other
What strategies did you use to avoid social media today?
Deleted apps
Turned off notifications
Spent time on hobbies
Physical activity
Reached out to friends/family
Other
How challenging was it to avoid social media today?
*
Not challenging
1
2
3
4
5
6
7
8
9
Extremely challenging
10
1 is Not challenging, 10 is Extremely challenging
How did you feel today while avoiding or reducing social media?
Positive/Empowered
Neutral
Frustrated/Irritable
Anxious
Other
Did you experience any setbacks today?
*
Yes
No
If you had a setback, please describe what happened and how you responded.
Support System Check: Did you reach out to anyone for support today?
Yes
No
What is your goal for tomorrow regarding social media use?
Additional notes or reflections
Submit Log
Should be Empty: