Daily Routine Form

Walks parents, caregivers, or educators through mapping someone's daily schedule step by step, from wake-up to bedtime.

Use this template

Name

Nombre

Apellido

Waking Up

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What time do you wake up every day?

Getting Ready

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What time do you take a shower?

What time do you get dressed?

Breakfast

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Does your family eat breakfast together?

Yes No

What time do you eat breakfast?

Family

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Do you have children?

Yes No

Commute

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Do you take the bus?

Yes No

Do you drive?

Yes No

School

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What time do you go to school?

Errands

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Do you go to the grocery store for your family?

Yes No

Work

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What time do you leave work?

Household Chores

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What time do you clean the house?

Do you exercise?

Yes No

Making Dinner

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Do you cook dinner?

Yes No

Dinner Time

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What time do you eat dinner?

Homework

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What time do you do your homework?

Reading Time

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Do you like to read the paper?

Yes No

TV Time

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What time do you watch TV?

Bedtime

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What time do you go to bed?

Sleep

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What time do you go to sleep?

Daily Routine Form

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