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IC Food and Trigger Log, free printable

Use this weekly food and trigger log to track meals, drinks, supplements, non-food notes, and symptom scores in one place. It is for comparing symptom days with what else was happening around them.

Updated May 2026. By Intero.

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What is on the form

  • Seven-day grid by meal and time
  • Beverages and supplements row
  • Non-food context row for activity, posture, products, and stress
  • Symptom score column from 0 to 10
  • Notes column for surrounding details

How to use it

  1. 01Record entries during the day when possible.
  2. 02Include drinks and supplements if they matter to your tracking.
  3. 03Use the non-food row for things like sitting, activity, stress, or product exposure.
  4. 04After two weeks, look for repeated context around days when symptoms got worse.

Common questions

Do I have to measure portions?
No. This form is for practical symptom tracking, not nutrition analysis. Add portions only if a clinician asks you to.
Is this only about food?
No. It includes non-food context because pelvic and urinary symptoms can be affected by more than meals alone.
Is the form really free?
Yes. The PDF is free to download.
Intero

A private iPhone app for tracking pelvic pain, bladder symptoms, flare-ups, and appointment notes.

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Intero is not a medical device and does not provide medical advice, diagnosis, or treatment. The app and site are for personal symptom tracking and informational purposes only. Talk to a qualified healthcare provider about medical concerns.