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Symptom Monitoring: Basic Form
(Click here to view an example of a completed form.)


Trigger
(Internal or External):




 
Automatic Thoughts
(Things that I Assume are True) (% out of 100%):
 



Discomfort Level (0-10):



 
Behavior
(Things I Did; Things Observable to Others):



 
Dispute the Automatic Thoughts
(Possible Alternative Viewpoints):



 
Discomfort Level:



 
New Behavior or Plan of Action:
(i.e. Fight Maladaptive Thoughts &/or Engage in Pro-Active Behavior):