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Other Observations
Comments)***
Feces and
1-5
(Scale
Trial
Elimination Signs Comments)** and
Dietary Clinical 0-5 (Scale
for
Diary Items
Other Ingested*
Consumed
Food
Food Offered
Date
Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Figure 31-6. Example of a diary that can be maintained at home by clients during a food elimination trial.
