Self-Reliant Wellness logo

DBT Daily Diary Card

Mind & Body Self-Care · utah23.org

Saved on this device
How to use this & what each rating means

Fill it out daily. Tap a day to open it, then tap the numbers/Yes-No buttons and jot an insight. Everything saves automatically on this device as you go — you can close the page and come back.

Bookmark it: on your phone use your browser's Add to Home Screen; on a computer just bookmark the page. It opens right back to your saved entries.

Send it weekly: tap Export to PDF to download the PDF, then email or share that file with your therapist. When you start a new week, tap Clear all.

Unhelpful Behaviors — Self-Harm, Suicidal Ideation, Addiction Use: rate the urge 0–5 (0 = none, 5 = very strong), then mark Yes/No if you acted on it.
Physical Care — Bed/Wake time, Rest level 0–10 (0 = not rested, 10 = fully rested), Healthy sleep habits Y/N; Meds and each meal Y/N.
Nervous System Safety (0–5) — Happy/Calm, Strong Heavy Emotions, Physical Safety, Emotional Safety.
Insight gained today — what you learned or understood: a trigger you noticed, what felt difficult, a deeper meaning, or a positive experience.

Your entries are stored only in this browser on this device. Nothing is uploaded — it leaves your device only when you export and send the PDF.