Daily Check-In Tracker

A two-minute ritual that tells you both what kind of day each of you is having — without long conversation. Numbers replace the guesswork of reading body language.

Safety note: This worksheet is for consensual relationships where both partners can say yes, no, wait, or stop without punishment. Do not use this worksheet to pressure sexual activity. If there is fear, coercion, retaliation, active abuse, trauma flooding, pain, shutdown, or dissociation, pause and use this with a qualified therapist.

How to use this worksheet

Each partner fills out their own row each day. Same time each day works best. Trade. Read silently. Notice patterns over the week. Don't argue with the numbers — they're a self-report, not a verdict. If energy is at 3, don't plan a big night. If closeness is at 8, protect the moment.

Name

______________________________________________

Week of

______________________________________________

Weekly tracker — rate each 1-10

Monday

Date

______________________________________________

Body well-being

Rate from 1 to 10: ____

How much energy

Rate from 1 to 10: ____

Anxious / worried

Rate from 1 to 10: ____

Down / sad

Rate from 1 to 10: ____

Close to partner

Rate from 1 to 10: ____

Open to intimacy

Rate from 1 to 10: ____

Tuesday

Date

______________________________________________

Body well-being

Rate from 1 to 10: ____

How much energy

Rate from 1 to 10: ____

Anxious / worried

Rate from 1 to 10: ____

Down / sad

Rate from 1 to 10: ____

Close to partner

Rate from 1 to 10: ____

Open to intimacy

Rate from 1 to 10: ____

Wednesday

Date

______________________________________________

Body well-being

Rate from 1 to 10: ____

How much energy

Rate from 1 to 10: ____

Anxious / worried

Rate from 1 to 10: ____

Down / sad

Rate from 1 to 10: ____

Close to partner

Rate from 1 to 10: ____

Open to intimacy

Rate from 1 to 10: ____

Thursday

Date

______________________________________________

Body well-being

Rate from 1 to 10: ____

How much energy

Rate from 1 to 10: ____

Anxious / worried

Rate from 1 to 10: ____

Down / sad

Rate from 1 to 10: ____

Close to partner

Rate from 1 to 10: ____

Open to intimacy

Rate from 1 to 10: ____

Friday

Date

______________________________________________

Body well-being

Rate from 1 to 10: ____

How much energy

Rate from 1 to 10: ____

Anxious / worried

Rate from 1 to 10: ____

Down / sad

Rate from 1 to 10: ____

Close to partner

Rate from 1 to 10: ____

Open to intimacy

Rate from 1 to 10: ____

Saturday

Date

______________________________________________

Body well-being

Rate from 1 to 10: ____

How much energy

Rate from 1 to 10: ____

Anxious / worried

Rate from 1 to 10: ____

Down / sad

Rate from 1 to 10: ____

Close to partner

Rate from 1 to 10: ____

Open to intimacy

Rate from 1 to 10: ____

Sunday

Date

______________________________________________

Body well-being

Rate from 1 to 10: ____

How much energy

Rate from 1 to 10: ____

Anxious / worried

Rate from 1 to 10: ____

Down / sad

Rate from 1 to 10: ____

Close to partner

Rate from 1 to 10: ____

Open to intimacy

Rate from 1 to 10: ____

Weekly review

Trade trackers at the end of the week. Look for patterns, not single days.

What was our highest closeness day? What were we doing?

______________________________________________

______________________________________________

______________________________________________

Did energy or anxiety patterns line up between us?

______________________________________________

______________________________________________

______________________________________________

Was there a day one of us was hurting and the other didn't see it?

______________________________________________

______________________________________________

______________________________________________

Based on this week, what's one thing to try differently next week?

______________________________________________

______________________________________________

______________________________________________

Missed days don't count against you: A week with three check-ins is a week with three check-ins. Start the next page fresh.

Go deeper

Ready for more? These lessons pick up where this worksheet leaves off.

• Staying Close, from The Neurodiverse Couples Repair Program. Stay close in ordinary weeks: small daily moments and a short check-in that fits you both.
• Co-Regulation as a Couple, from The Neurodiverse Couple. How two nervous systems settle each other — why co-regulation can misfire across neurotypes, and how to build a calm the two of you can borrow.
• Neurodiverse Relationships, from The Neurodivergent Brain. Neurodiverse relationships: the double empathy problem, four couple patterns, and what helps.