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Log your Road to Recovery Daily
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* Indicates required question
Name
*
Your answer
Date
MM
/
DD
/
YYYY
List 3 things you are grateful for
*
Your answer
Mindfulness
*
Yes
No
Required
Daily 20 min Walks
*
0
1
2 or more
Required
Sleep
*
0-3 hours
4-6 hours
6-8 hours
> 8 hours
Required
Daily Steps
*
0-3000
3001-6000
6001-9999
10000 or more
Required
General Exercise
*
0-5 minutes
6-10 minutes
11-15 min
16-20 min
20 min or more
Required
Daily Dozen Score
*
0-20
21-40
40-60
60-80
80 or more
Required
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