Sodium Record
Use this form to record the sodium content of the foods you eat or drink each day. This record will help you see whether you are getting the prescribed daily amount of sodium in your diet.
Take this record with you when you visit your health professional.
My doctor recommends that I have ___________milligrams (or ______ grams) of sodium in my diet each day.
|
Meal |
Foods and beverages consumed during the meal |
Total milligrams (or grams) of sodium in each meal |
| Breakfast
| ||
| Snack
| ||
| Lunch
| ||
| Snack
| ||
| Dinner
|
Credits
| By: | Reference Healthwise Staff | Last Revised: July 12, 2012 |
| Medical Review: | Reference Kathleen Romito, MD - Family Medicine
Reference Rhonda O'Brien, MS, RD, CDE - Certified Diabetes Educator |
|
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