Food Journal Template
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1Name:
Date:
Day:
Hunger Scale 0=Starved
10=Overly Full
Time
Food and Beverage/Quantity
Previous
Hunger
Mood, thoughts and/or feelings
Binge? Purge?
Comments
Activity
Scale
__10
__9
__8
__7
__6
__5
__4
__3
__2
__1
__0
__10
__9
__8
__7
__6
__5
__4
__3
__2
__1
__0
__10
__9
__8
__7
__6
__5
__4
__3
__2
__1
__0
__10
__9
__8
__7
__6
__5
__4
__3
__2
__1
__0
__10
__9
__8
__7
__6
__5
__4
__3
__2
__1
__0
__10
__9
__8
__7
__6
__5
__4
__3
__2
__1
__0
__10
__9
__8
__7
__6
__5
__4
__3
__2
__1
__0
__10
__9
__8
__7
__6
__5
__4
__3
__2
__1
__0
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Parent category: Miscellaneous