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Parkinson's Disease Daily Symptom Tracker

A comprehensive monitoring tool for patients with Parkinson's disease

Neurology

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Template Content

Last updated: Mar 24, 2025

Patient Information

Name: _________________ Date: _________________ Medication Schedule: _________________

Morning Assessment (6 AM - 12 PM)

Motor Symptoms (Rate 0-4, 0=None, 4=Severe)

  • Tremor: ___
  • Stiffness: ___
  • Balance issues: ___
  • Walking difficulty: ___

Medication Response

  • Time taken: _____
  • Time to effect: _____
  • Duration of effect: _____

Afternoon Assessment (12 PM - 6 PM)

Motor Symptoms

  • Tremor: ___
  • Stiffness: ___
  • Balance issues: ___
  • Walking difficulty: ___

Non-Motor Symptoms (Check if present)

□ Fatigue □ Anxiety □ Depression □ Sleep problems

Evening Assessment (6 PM - Bedtime)

Motor Symptoms

  • Tremor: ___
  • Stiffness: ___
  • Balance issues: ___
  • Walking difficulty: ___

Daily Activities (Check if difficult)

□ Eating □ Writing □ Dressing □ Personal hygiene

Additional Notes

Side effects: ________________ Other concerns: ________________

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