Wellbeing check-in printable
A free mental health tracker printable: a monthly grid to rate mood, energy, sleep, stress, time outside and time with people from one to five, once a day. It is a check-in for patterns, not a test.
Updated 21 October 2026. Sources named on the page.
- Six lines rated one to five each day
- A 31 day grid on one page
- A4 and US Letter, black and white friendly
- A check-in, not a test or a diagnosis
What is on the sheet
- Six lines: mood, energy, sleep, stress, time outside, time with people
- 31 day columns
- A note with a support line
- A4 and US Letter
The picture shows the A4 wellbeing check-in printable. The US Letter version has the same layout.
How to use it
Once a day, ideally at the same time, put a number from one to five in each line, where five is high. It should take under a minute. Do not worry about being exact: the pattern across the month matters more than any single day.
Why these six lines
Mood, energy, sleep and stress move together for many people, and time outside and time with others are things you can choose. Seeing them side by side can show which days were harder and what came before them.

Reading it at the end of the month
Look for runs rather than single days: several low days in a row, or a line that rises on days you were outside. Write one sentence about what you notice. If something concerns you, take the sheet to a doctor or counsellor.
Keep it where you will see it
A sheet in a drawer does not get filled in. Put it by the kettle, next to the toothbrush or on the inside of a wardrobe door, and rate the day at the same moment each evening. Ten seconds with a pen is the whole habit.
Be kind with the numbers
A low number is information, not a failure, and a missed day is only a blank box. Do not score yourself on the score. The point of a month of ratings is to notice what helps, and to have something concrete to say if you ever ask for support.
What this is and is not
It is a blank page for your own notes. It cannot diagnose anything and it does not replace care. If you are struggling, please talk to your doctor or a support line such as Lifeline on 13 11 14, any time.



Paper or app
Paper is private and simple. If you would like the same check-in with a chart, plus sleep and habits in one private place, the Daily Journal does that, and the first three habits are free.
Questions
Is this a test for depression or anxiety?
No. It is a self check-in for noticing your own patterns. Only a health professional can assess how you are.
How is it different from the mood tracker?
The mood tracker follows one line. This one rates six lines each day, so you can see how mood sits beside sleep, stress and time outside.
What if my numbers are low for a while?
Talk to your doctor or a support line such as Lifeline on 13 11 14. The sheet is a record you can bring with you.
Should I rate the day or the moment?
Rate the day as a whole, at the same time each evening, so the numbers are comparable. If one moment stood out, write it in the margin.
Does it come in A4 and US Letter?
Yes. Both sizes have the same layout.
Keep going
Keep going after the wellbeing check-in printable
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