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Ovarian Cancer Symptom and Treatment Tracking Journal

Daily Monitoring Tool for Patients

Oncology

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Template Content

Last updated: Mar 24, 2025

Personal Information

Name: _________________ Date of Diagnosis: //___ Oncologist: _________________ Contact: _________________

Daily Symptom Tracker

Date: //___

Pain Level (0-10)

□ 0-2 (Mild) □ 3-5 (Moderate) □ 6-8 (Severe) □ 9-10 (Extreme) Location: _________________

Fatigue Level

□ None □ Mild □ Moderate □ Severe Hours of sleep: ___

Gastrointestinal Symptoms

  • Nausea: □ Yes □ No
  • Vomiting: □ Yes □ No
  • Appetite: □ Normal □ Decreased □ None
  • Bowel movements: ___ per day

Other Symptoms

  • Bloating: □ Yes □ No
  • Abdominal swelling: □ Yes □ No
  • Urinary frequency: □ Normal □ Increased

Treatment Record

Medications

Medication Name Dose Time Taken Side Effects

Appointments

Date Provider Notes

Questions for Healthcare Team

Notes

Emergency Contacts

Oncologist: _________________ Nurse Navigator: _________________ Emergency Room: _________________

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