Basal Body Temperature Chart For Patient
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1Patient's Name: ____________________________________
Basal Body Temperature Chart
Month(s) ________________________ Year ___________
Last 12 Cycles:
Shortest: ____________
Longest: ____________
This Cycle's Length: ___________
Cycle Day
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8
9
10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45
Date
Day of Week
Time Temp Taken
99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99 99
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3
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3
3
3
3
3
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3
2
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2
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2
2
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2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Waking
98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98 98
Temperature
9
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4
4
3
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3
3
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3
2
2
2
2
2
2
2
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2
2
2
2
2
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2
2
2
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2
2
2
2
2
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2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97 97
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9
Cycle Day
1
2
3
4
5
6
7
8
9
10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45
Ovalation Test
Intercourse
Increased Sex Drive
Cervical Mucus:
Thick, Sticky
Scanty/Dry
PMS Symptoms:
Irritability
Headaches
Bloating
Breast Tenderness
Craving Food
Depression
Period Color:
Light Red/Pink
Dark Red
Brown
Bright Red
Heavy
Clots
Spotting
Period Cramps:
Severe
Mild
Moderate
(Yin/Blood)
Vaginal Dryness
Night Sweats
Warm Palms/Soles
Dry Mouth/Eyes
Face Breakout
Dry Hair/Hair Loss
(Yang)
Lower Back Pain
Cold Feet
Nighttime Urine
Low Libido
Fatigue
Vaginal Discharge
Cycle Day
1
2
3
4
5
6
7
8
9
10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45
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