Diet Diary Diet Diary Diet Diary Name* First Last Email* Date* MM slash DD slash YYYY 1. Bowel function – stool characteristics (please give one answer for each of the following)Stool Color* dark very dark pale very pale green Stool Consistency* loose very loose hard very hard Smell* no smell light smell strong smell very strong smell Frequency of Stools per day* once twice three times more has not pass motion for more than a day has not pass motion for more than two days has not pass motion for more than three days has not pass motion for a week has not pass motion for more than a week 2. Please list your medication and/or supplementation.DescribePlease write below your diet diary in a giving weekMondayTuesdayWednesdayThursdayFridaySaturdaySundayIn case you need to upload a file please click belowMax. file size: 512 MB. Consent* I explicitly consent to you creating and storing medical records concerning my child’s treatment, which may include details concerning medication, treatment and other issues affecting his/hers health conditions, in accordance with the General Data Protection Regulation (GDPR). I understand that these records will be processed in accordance with your 2018 Privacy Notice, a copy of which I have seen published on IBCcare website. I have read and understood the above information and give my explicit consent:
