Skip to main content

Printable

Printable fibromyalgia symptom diary

A one-page sheet with seven dated rows, for a week of symptoms. Print it, fill it in by hand, and take it to your next appointment.

One page, 7 rows, US Letter or A4. The preview scrolls sideways; printing gives you the sheet alone.

Daily symptom diary

One row a day for a week. Leave anything you did not record blank.

Name (optional)Week beginning

Seven blank days. Each row has a date, where the pain was and how bad, fatigue, sleep, thinking and memory, what you did or could not do, and room for notes and questions.
DatePain: wherePain /10Fatigue /10SleepThinking /10What I did / missedNotes and questions
Day 1, date
Day 2, date
Day 3, date
Day 4, date
Day 5, date
Day 6, date
Day 7, date

A blank means not recorded. It does not mean zero. If when a symptom started, how long it lasted, or how often it happens matters that day, write it in the notes column.

This sheet is a record of what you report. It cannot diagnose any condition, explain a symptom, prove what caused one, or replace clinical assessment or care from your own doctor.

Prefer to keep it on a phone? The guide explains the same record, and Tend on the App Store is an iPhone and iPad app from Off Script Foundry, Inc. that keeps it for you. The paper sheet is complete on its own.

01

What is on the sheet

Each row is one day. The columns are details NIAMS and the National Institute on Aging say a doctor may ask about, and the guide explains where each one comes from.

  • Pain: where. The areas that hurt today, in your own words.
  • Pain /10. A number from 0 to 10, or the same few words each time.
  • Fatigue /10. How tired you were, on the same scale each time.
  • Sleep. Roughly how long you slept, and how the night went.
  • Thinking /10. Trouble concentrating, thinking clearly, or remembering.
  • What I did / missed. What you did, and anything you could not do that day.
  • Notes and questions. Anything else, and what you want to ask at the next visit.

When a symptom started, how long it lasted and how often it happens have no column of their own. At this width the box would be too small to write a sentence in, so they go in the notes column, where there is room.

02

How to use it

  1. Print it. One sheet covers 7 days, so one page a week, and it fits US Letter and A4 without changing anything.
  2. Write the date in the first column. A line with no date cannot be placed on a timeline or compared with another day.
  3. Fill in what you can. Use the same scale every day, so two days can be compared.
  4. Leave the rest blank. A blank means not recorded; writing 0 for “I don’t know” turns a gap into a reading.
  5. Take it with you. The National Institute on Aging suggests making some notes about your symptoms before you call or visit the doctor.

This webpage collects nothing you write

The sheet is a table of empty boxes. There is no field to type in, nothing is saved, and no request is sent. This webpage cannot receive, save, or send what you write by hand.

03

What the sheet cannot do

  • It cannot diagnose anything. The sheet records what you report. Diagnosis is clinical assessment, and NIAMS describes how fibromyalgia is diagnosed.
  • It cannot explain a symptom or prove a cause. Two things written on the same row happened on the same day, and that is all a row says.
  • It cannot replace medical care. It is something to bring to your own doctor. It is not a substitute for clinical assessment or for care.
04

Sources

The column headings, and the details this page says a doctor may ask about, are narrow paraphrases of three public pages from the United States National Institutes of Health, all read on 17 September 2026 and listed in full, with links, in the symptom diary guide: the NIAMS fibromyalgia overview, the NIAMS page on diagnosis and steps to take, and the National Institute on Aging’s page on what to tell the doctor. The rest of this page describes the sheet itself: its layout, how to fill it in, and what it cannot do. Those are ours, and no source is claimed for them.

This sheet is designed and published by Off Script Foundry, Inc., the company that publishes Tend. No clinician has checked it, and the byline at the top of this page says so. The editorial policy sets the rules it is written to, and the address at the foot of this page reaches the person responsible for correcting it.

Sources last checked: 17 September 2026. No later check is scheduled.

What this page does not say

  • It does not diagnose fibromyalgia or anything else.
  • It does not say what causes a symptom or a bad day.
  • It does not recommend a medication, supplement, diet or exercise.
  • It does not require an app, an account, or a phone.
  • No clinician has checked it. It paraphrases three public NIH pages.

Tend is a self-tracking tool. It is not a medical device, it does not diagnose or treat anything, and it is not a substitute for care from your own doctor. Something wrong on this page? Email contact@offscriptfoundry.com. The editorial policy says how corrections are handled. Off Script Foundry, Inc. is responsible for every statement here.