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Exposure Tracking Log
Name
Your answer
Date and time
MM
/
DD
/
YYYY
Description of exposure
Your answer
Pre Exposure Anxiety Level
Minimal
1
2
3
4
5
6
7
8
9
10
Extreme
What sensations and thoughts are you noticing?
Your answer
Anxiety Level: 1 minute into exposure
1
2
3
4
5
6
7
8
9
10
What sensations and thoughts are you noticing?
Your answer
Anxiety Level: 5 minutes into exposure
1
2
3
4
5
6
7
8
9
10
Anxiety Level: 10 minutes into exposure
1
2
3
4
5
6
7
8
9
10
What sensations and thoughts are you noticing?
Your answer
Any key takeaways or lessons learned from this exercise?
Your answer
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