Version July 2025
| Date | What time did the headache start? | Pain level (1-10)? | Where was the pain? | Did you have other symptoms (like nausea or muscle pain)? | What were you doing when the headache started? | What did you eat or drink before the headache? | What did you do to try to get relief? (behaviors and/or medicines taken [name and dose]) | Did the behaviors or medicines help? | What time did the headache end? |
| Example: | |||||||||
| January 5 | 9:00am | 6 | Both sides of head | No | Working on the computer | Coffee and bagel | Rested in a dark room, took ibuprofen 600 mg | Yes | 11:00am |
