DAILY WEIGHT LOG
INSTRUCTIONS:
1.) Weigh
y ourself
f irst
t hing
e ach
m orning,
b efore
y ou
h ave
a nything
t o
e at
o r
d rink.
2.) Before
y ou
w eigh
y ourself,
e mpty
y our
b ladder.
W ear
t he
s ame
l evel
o f
c lothing
( less
i s
b etter)
e ach
day.
3.) Record
y our
w eight
i n
t his
l og
a nd
t rack
h ow
y ou
f eel.
B ring
t his
l og
t o
y our
c linic
a ppointments.
MY
T ARGET
W EIGHT
I S:
_ _____
( lbs.)
_ _____
( kg)
DATE:
DAY
O F
W EEK
WEIGHT
Heart
F ailure
Z one:
G reen,
Y ellow,
R ed
Monday
_______________
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
DATE:
DAY
O F
W EEK
WEIGHT
Heart
F ailure
Z one:
G reen,
Y ellow,
R ed
Monday
_______________
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
DATE:
DAY
O F
W EEK
WEIGHT
Heart
F ailure
Z one:
G reen,
Y ellow,
R ed
Monday
_______________
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
DATE:
DAY
O F
W EEK
WEIGHT
Heart
F ailure
Z one:
G reen,
Y ellow,
R ed
Monday
_______________
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Call
y our
h ealth
c are
p rovider
i f
y ou
g ain
4
l bs.
( 2
k g)
o ver
2
d ays
i n
a
r ow,
or
i f
y ou
g ain
5
l bs.
( 2.5
k g)
i n
o ne
w eek.