Honest Drinking Log — 14-Day Template. Fill in the fields below (by typing on screen or by hand after printing), then use the Print button to save as PDF or print to paper. Bring this to your next consultation.
Bring this to your next consultation · Para sa inyong doktor
W. G. M. Rivero, MD, FPCP, DPSN
Nephrology & Internal Medicine · PRC 0105184
Why honesty matters here. Your nephrologist cannot adjust your medications, BP plan, or dialysis schedule without knowing what you actually drink. Estimates are useless — write down what you actually consumed each day, not what you wish you had. This log is for you first, your doctor second. It will not be filed in any system you don't control.
Day
Date
What I drank
How much
Std drinks
Trigger / context
AM feeling (0–10)
BP (if measured)
Total drinks this 2-week period—
Average per day—
Days with ≥4 drinks (binge)—
KDIGO 2024 — healthy adult
Women ≤1 drink/day · Men ≤2 drinks/day
CKD st. 3 with HTN or DM
≤0.5 drinks/day (~3 drinks/week)
One "standard drink" = 14 g pure ethanol. SMB Pale Pilsen 330 mL ≈ 0.9 drink · Red Horse 500 mL ≈ 1.9 · Tanduay/Lambanog shot 30 mL ≈ 0.7 · Wine 150 mL ≈ 1.0.