Addiction Recovery Daily Check-In Questionnaire Form
Complete this daily check-in to reflect on your recovery journey. All responses are confidential and intended for your personal growth.
Date of Check-In
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
How would you rate your overall mood today?
*
Very Low
1
2
3
4
5
6
7
8
9
Very High
10
1 is Very Low, 10 is Very High
How intense were your cravings today?
*
None
1
2
3
4
5
6
7
8
9
Extreme
10
1 is None, 10 is Extreme
Did you experience any triggers today?
*
Yes
No
If yes, what were your main triggers?
What coping strategies did you use today?
Reached out to support
Attended a meeting
Exercised
Practiced mindfulness
Other
How would you rate your sleep quality last night?
Poor
1
2
3
4
5
6
7
8
9
Excellent
10
1 is Poor, 10 is Excellent
Did you connect with your support network today?
Yes
No
What is one thing you are proud of today?
Any additional thoughts or reflections?
Submit Check-In
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