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Brain Tumor Care Tracking Sheet

Daily Monitoring and Symptom Journal

Neurology

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Last updated: Mar 24, 2025

Patient Information

Name: ___________________ Date of Diagnosis: //___ Treating Physician: ___________________ Contact: _______________

Daily Symptom Tracker

Rate your symptoms (0-10 scale)

Date: //___

  • Headache: ___
  • Nausea: ___
  • Vision Changes: ___
  • Balance Issues: ___
  • Weakness: ___
  • Memory/Confusion: ___

Medication Log

Medication Dose Time Taken Side Effects

Seizure Record

  • Date/Time: ___________
  • Duration: ____________
  • Type: ________________
  • Triggers: _____________

Activities & Function

  • Hours of Sleep: ___
  • Activity Level (Low/Medium/High): ___
  • Able to Perform Daily Tasks? Yes/No
  • Notes: ________________

Medical Appointments

Date Provider Purpose Follow-up Notes

Questions for Healthcare Team

Emergency Contacts

Primary: _________________ Phone: _____________ Neurologist: ______________ Phone: _____________ Emergency Dept.: __________ Phone: _____________

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