Personal Care:
Actionable Item | Tick if Yes | Comment if any | ||
|---|---|---|---|---|
A | B | C | ||
1 | Did I wake up at my desired time? | |||
2 | Did I brush my teeth and floss? | |||
3 | Did I wash my face/shower? | |||
4 | Did I get dressed? | |||
5 | Did I take my medications/vitamins? | |||
6 | Did I do my skincare routine? | |||
7 | Did I style my hair? |
Mind and Body:
Actionable Item | Tick if Yes | Comment if any | ||
|---|---|---|---|---|
A | B | C | ||
1 | Did I drink a glass of water? | |||
2 | Did I meditate/practice mindfulness? | |||
3 | Did I exercise/stretch? | |||
4 | Did I eat a healthy breakfast? | |||
5 | Did I plan my day/set intentions? | |||
6 | Did I read something positive/inspirational? |
Work/Study (if applicable):
Actionable Item | Tick if Yes | Comment if any | ||
|---|---|---|---|---|
A | B | C | ||
1 | Did I review my schedule/to-do list? | |||
2 | Did I prepare for my work/studies? | |||
3 | Did I check my emails/messages? |
Productivity:
Actionable Item | Tick if Yes | Comment if any | ||
|---|---|---|---|---|
A | B | C | ||
1 | Did I work on my most important task(s)? | |||
2 | Did I take breaks throughout the day? | |||
3 | Did I manage my time effectively? | |||
4 | Did I complete my assigned tasks? | |||
5 | Did I prioritize my tasks? | |||
6 | Did I avoid distractions? |
Health and Wellbeing:
Actionable Item | Tick if Yes | Comment if any | ||
|---|---|---|---|---|
A | B | C | ||
1 | Did I drink enough water? | |||
2 | Did I eat a healthy lunch? | |||
3 | Did I move my body/stretch? | |||
4 | Did I take some time for myself? | |||
5 | Did I practice gratitude? |
Social/Personal:
Actionable Item | Tick if Yes | Comment if any | ||
|---|---|---|---|---|
A | B | C | ||
1 | Did I connect with family/friends? | |||
2 | Did I engage in a hobby/passion? | |||
3 | Did I learn something new? |
Winding Down:
Actionable Item | Tick if Yes | Comment if any | ||
|---|---|---|---|---|
A | B | C | ||
1 | Did I prepare for tomorrow? | |||
2 | Did I reflect on my day? | |||
3 | Did I avoid screens before bed? | |||
4 | Did I read a book/relax? | |||
5 | Did I practice relaxation techniques? |
Sleep Hygiene:
Actionable Item | Tick if Yes | Comment if any | ||
|---|---|---|---|---|
A | B | C | ||
1 | Did I go to bed at my desired time? | |||
2 | Did I prepare my sleep environment? | |||
3 | Did I turn off the lights? |
Actionable Item | Tick if Yes | Comment if any | ||
|---|---|---|---|---|
A | B | C | ||
1 | Did I drink enough water throughout the day? | |||
2 | Did I eat healthy and balanced meals? | |||
3 | Did I practice mindfulness throughout the day? | |||
4 | Did I express gratitude for something? | |||
5 | Did I learn something new today? | |||
6 | Did I do something kind for myself or others? |
Form Template Instructions
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Customization:
Strengths:
Potential Areas for Consideration and Improvement:
In summary: This is a great starting point for a daily routine checklist. Its comprehensiveness is a strength, but remember to tailor it to your individual needs and start small to avoid feeling overwhelmed. Regular review and adjustment are key to making it a truly effective tool for building positive habits and achieving your goals.
To configure an element, select it on the form.