How to put together a behavioral modification journal

Hi Everyone -

I am new here and not really sure what I'm doing yet.  I posted a blog but now found this forum and think this may be better suited.

Here is my question.  I have one last task to complete before my insurance Blue Cross / Blue Shield will okay my surgery and that is putting together a Behavioral Modification Journal.  I want to mirror it with the time I spent on the Jenny Craig program but I'm not really sure how to do this.  Does anyone have a sample of how this should look?

Any help anyone can give me would be greatly appreciated!

Tons of smiles your way,
Jennifer