By Andrew Newlun
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Media
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Pic of the Day
Contact
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By Andrew Newlun
Services
Media
More...
Pic of the Day
Contact
0
Daily Evaluation
Andrew Daily Eval
How much sleep did you get last night?
*
Less than 4 hours
4 to 5 hours
5 to 6 hours
6 to 7 hours
7 to 8 hours
8 to 9 hours
9 plus hours (bad)
9 plus hours (needed)
What time did you wake up this morning?
*
Hour
Minute
Second
AM
PM
Did you take a nap today?
*
Yes
No
If nap, was it needed?
Yes
No
Did you have a significant amount of caffeine today
*
Yes
No
Did you exercise today?
*
Yes
No
If exercised, how long?
less than 1 Hour
1 to 2 hours
2 to 3 hours
3 plus hours
If exercised, what type?
If exercised, what time of day?
Hour
Minute
Second
AM
PM
Alertness rating across whole day?
*
1
2
3
4
5
6
7
8
9
10
Did you meditate today?
*
Yes
No
If meditated, what type?
Deep prayer
Breath Focus
Mindfulness
Guided
did meditation have a tangible impact on your thoughts, emotions, or behavior?
Yes
No
Did you read today?
*
Yes
No
If read, what book?
did the book have a tangible impact on your thoughts, emotions, or behavior?
Yes
No
Did you study today?
*
Yes
No
If studied, what?
did your studying have a tangible impact on your thoughts, emotions, or behavior?
Yes
No
Did you learn a skill today?
*
Yes
No
If yes, what skill?
Did you listen to music today?
*
Yes
No
If yes, what genre?
did the music have a tangible impact on your thoughts, emotions, or behavior?
Yes
No
Did you play music today?
*
Yes
No
did playing music have a tangible impact on your thoughts, emotions, or behavior?
Yes
No
Did you work more at home or away today
*
Home
Away
Perceived quality of work day
*
1
2
3
4
5
6
7
8
9
10
% of day operating in emotion
*
10
20
30
40
50
60
70
80
90
100
% of day operating in mind
*
10
20
30
40
50
60
70
80
90
100
% of day operating in spirit
*
10
20
30
40
50
60
70
80
90
100
Kids were in a good mood today
*
Kids Mood
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
How much time spent with kids today
*
less than 1 hour
1 to 2 hours
2 to 3 hours
3 to 4 hours
4 to 6 hours
6 to 8 hours
8 plus hours
Wife was in a good mood today
*
Wife Mood
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
How much time spent with wife today
*
less than 1 hour
1 to 2 hours
2 to 3 hours
3 to 4 hours
4 to 6 hours
6 to 8 hours
8 plus hours
Other people were in a good mood today
*
Peoples Mood
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
How much time spent with other people today
*
>1 hour
1 to 2 hours
2 to 3 hours
3 to 4 hours
4 to 6 hours
6 to 8 hours
8 plus hours
There were several impactful/major events that happened today
*
Events happened
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Overall Day Rating
*
1
2
3
4
5
6
7
8
9
10
Additional Notes / Journal
Thank you!
