Brain Tumor Symptoms and Treatment Tracking Sheet

Patient Information

Name: _________________ Date of Diagnosis: _________________ Treating Physician: _________________

Daily Symptom Tracker

Neurological Symptoms (Rate 0-10)

• Headache intensity: ___
• Vision changes: ___
• Balance issues: ___
• Speech difficulties: ___
• Memory problems: ___

Physical Symptoms

• Nausea: □ None □ Mild □ Moderate □ Severe
• Vomiting episodes: ___ (number per day)
• Fatigue level: □ Low □ Medium □ High
• Seizure activity: □ Yes □ No
  • If yes, duration: ___
  • Time of occurrence: ___

Treatment Tracking

Medications

Radiation/Chemotherapy Sessions

Important Notes

• Record any new or worsening symptoms
• Document all medication changes
• Note missed doses and reasons
• Track appointment dates

Emergency Contacts

Oncologist: _________________ Emergency Number: _________________ Caregiver: _________________

*Contact your healthcare team immediately if you experience:

• Severe headaches unrelieved by medication
• New onset seizures
• Sudden vision changes
• Confusion or personality changes
• Difficulty speaking or understanding speech*