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(6/8/2009) Ellen Dome Self monitoring form and instructions.doc Page 1 Self-Monitoring Form Day Time of day Hunger 1-10 Food and drink consumed Ellen Dome, Ph.D., R. Psych. Location Date * Fullness

How to fill out self-monitoring eating form

How to fill out a self-monitoring eating form:

1. Start by recording the date and time of each meal or snack.
2. Write down the type of food and portion size consumed.
3. Note any specific details about the meal, such as the location or company.
4. Keep track of your hunger levels before and after each meal or snack.
5. Record any emotions or triggers that may have influenced your eating choices.
6. Include any notes about cravings or food desires.
7. Add information about physical activity or exercise performed during the day.
8. Finally, review and reflect on your eating habits and patterns from the form to identify any areas for improvement and make necessary adjustments.

Who needs a self-monitoring eating form:

1. Individuals looking to improve their eating habits and maintain a healthy lifestyle.
2. People with dietary restrictions or specific health goals, such as weight loss or managing chronic conditions.
3. Individuals who want to gain insight into their eating behaviors and identify patterns or triggers that may affect their health or well-being.

For pdfFiller’s FAQs

What is self-monitoring eating form?

Self-monitoring eating form is a tool used to track food intake, eating habits, and behaviors to help individuals become more aware of their eating patterns and make healthier choices.

Who is required to file self-monitoring eating form?

Individuals who are looking to improve their eating habits and overall health are required to file a self-monitoring eating form.

How to fill out self-monitoring eating form?

To fill out a self-monitoring eating form, individuals can simply record their daily food intake, eating times, portion sizes, and any associated feelings or emotions.

What is the purpose of self-monitoring eating form?

The purpose of a self-monitoring eating form is to increase self-awareness, track progress towards health goals, and identify areas for improvement in eating habits.

What information must be reported on self-monitoring eating form?

Information such as food items consumed, portion sizes, eating times, and any emotions or feelings associated with eating must be reported on a self-monitoring eating form.

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