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Template library · Assessments & screeners

Sleep Diary Review template

Summarize patterns observed in the client's sleep diary and adjust the treatment plan.

Follow-up review of 2-week sleep diary data

  • 14 fields across 4 sections
  • Included with MyWellOps
  • Edit it, or save your own version

What’s in it

Assessment Details

  • Client NameText
  • Date of BirthDate
  • Client ID / MRNText
  • Date of AssessmentDate
  • Clinician / CoachText
  • Location / ModalityText

Diary Summary

  • Average total sleep timeText
  • Average time to fall asleep (sleep latency)Text
  • Number of night awakeningsText
  • Sleep efficiency trendText
  • Notable patterns (weekday vs weekend, stress correlation)Text

Plan Adjustments

  • Changes to recommend for next 2 weeksText

Signatures

  • Clinician SignatureSignature
  • Date signed (clinician)Date

When to use it

Use an assessment at the start of work to set a baseline, then repeat it at review points so you and the client can see what has changed.

How it works in MyWellOps

  1. Pick it from Documents.
  2. Send it to the client to complete, or fill it in together during a session.
  3. Each completed copy is kept on the client’s record, so earlier results are there to compare.

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