Mindfulness Tracking Sheet

At the heart of mindfulness is presence & awareness. Not being distracted or worrying about something other than what's going on around you. Below are a few questions we can use to rate & track your current level of mindfulness in your daily life.

Note: While working with me, we’ll fill this out from time to time so we can track your progress.

Name *
Name
Date *
Date
I find myself actively paying attention to the social media I’m consuming and not aimlessly scrolling. *
My spouse/partner/ kids/co-workers know that when we interact, they have my full attention. *
I pay attention to the way the media (social networking, movies, books, tv) I consume makes me feel. *
I notice things that I find interesting or beautiful around me (ex. a rock, cloud, someone’s new shoes) *
I am aware of how my body feels and what it needs. *
I find myself focused on the present and not lost thinking about the past or planning/worryi ng about the future. *
I make time to meditate daily. *
When I'm startled, I notice what feelings/emotio ns are going on in my body. *
I notice changes in my body, like my heart beating faster or muscles tensing up. *
I try to distract myself when I feel unpleasant or uncomfortable emotions. *
When I'm in the shower I'm aware of the sensations of water running over my body. *
I feel guilt/shame/jud gement around my thoughts or past actions. *
I make unplugged time away from screens part of my daily/weekly routine. *
When I think of someone/somet hing I'm grateful for, I let them know. *
I notice how foods and drinks affect my thoughts, bodily sensations, and emotions. *