Free template · PDF · US Letter
Free Printable Neuropathy Symptom Log (PDF)
| Date | Symptoms | Location | Severity (0–10) | Aggravated by | Relieved by | Sleep (0–10) |
|---|---|---|---|---|---|---|
How to use this sheet
- Print the PDF — one page covers about three weeks.
- Each day, check the symptoms present: burning, tingling, numbness, shooting pain, or weakness.
- Note the location — feet, lower legs, hands, or other — and rate the overall severity from 0–10.
- In the Aggravated by column, note anything that made symptoms worse: standing, walking, heat, cold, tight shoes, or poor sleep.
- In the Relieved by column, note what helped: rest, elevation, ice, heat, medication. Bring the filled log to your neurologist.
Questions
Is this log really free?
Yes. The PDF is free to download and print — no sign-up, no email.
What causes neuropathy symptoms to vary day to day?
Blood sugar levels (for diabetic neuropathy), activity, temperature, sleep quality, and medication timing can all influence daily symptom intensity. Recording these factors alongside severity helps your neurologist identify which variables are driving your fluctuations.
Should I log on days with no symptoms?
Yes — logging a 0-severity day is as informative as logging a bad one. Days without symptoms, tracked against what you did differently, often reveal the most useful patterns.
Is there an app version?
Yes — NerveLog for iPhone logs symptoms, location, and factors and shows patterns over time. Core is free, no account needed, and your data stays on your device.
Want the log to analyze itself?
NerveLog for iPhone tracks the same things in seconds and shows you the patterns — free core, no account, and everything stays on your device.