A Therapy Center for Autistic Girls & Women
She Rocks the Spectrum
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.