Tracking Chart for Level 1 and Level 2 Exercises for Vertigo
Make a chart with three columns and as many rows you need for your exercises. The chart can help you see your progress in the level 1 and level 2 exercises for vertigo.
Put the date in the first column. In the second column, write down how many times you did the exercise and whether you had your eyes open or closed. In the third column, write down how you felt when you did the exercise.
Make six copies, and use one for each exercise. Add any comments about how you feel.
See the example below.
Times/Eyes closed or open
Comments (how you feel, etc.)
Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine
Specialist Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Current as ofNovember 20, 2015