Blank 3 - DAILY ROUTINE PLANNER - No Time Slots

Blank 2 - DAILY ROUTINE PLANNER - 20 Minute Slots

Blank 1 - DAILY ROUTINE PLANNER - 15 Minute Slots

Example 2 - DAILY ROUTINE PLANNER STICKY NOTES - 15 minute time slots

Example 1 - DAILY ROUTINE PLANNER - 20 minute time slots

Click on either the Word or PDF icon below the form to open the document on your computer/device. Blank forms are available in Word or PDF format.  Example forms are available in PDF format only.  Alternatively, right click on any form and choose "Save image as.." to save it as a JPEG.  Forms may be edited and printed to suit your needs.

D  Daily Routine Planner

You can plan to carry out High, Medium and Low activities in the most useful way throughout the day.  If you have completed the Activity Categories form and Daily/Weekly Record of Activity they can also help you to consider a more balanced routine.  One example shows how you can use sticky notes to plan the days rest and activity periods, but not necessarily the detail of what you will actually be doing.  The routine can then be adjusted when you feel ready to increase activity (or decrease in the case of a relapse!).  If you use sticky notes you can move them around accordingly.  There are 2 examples and 3 blank templates of this form.

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ME Forms

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  Free forms, diaries and charts for the management of ME/CFS.  

(Myalgic Encephalomyelitis/Chronic Fatigue S​yndrome)