GLP‑1 injection log (printable)
Use this as a simple record of what happened (not a plan for what to do). If your prescriber’s schedule differs, follow your prescriber.
Name: ____________________
Start date: ____ / ____ / ____
| Date | Time | Medication | Dose | Site | Notes |
|---|---|---|---|---|---|
| ____ / ____ / ____ | ____ : ____ | ________________ | ________ | ________ | ____________________________ |
| ____ / ____ / ____ | ____ : ____ | ________________ | ________ | ________ | ____________________________ |
| ____ / ____ / ____ | ____ : ____ | ________________ | ________ | ________ | ____________________________ |
| ____ / ____ / ____ | ____ : ____ | ________________ | ________ | ________ | ____________________________ |
| ____ / ____ / ____ | ____ : ____ | ________________ | ________ | ________ | ____________________________ |
| ____ / ____ / ____ | ____ : ____ | ________________ | ________ | ________ | ____________________________ |
| ____ / ____ / ____ | ____ : ____ | ________________ | ________ | ________ | ____________________________ |
| ____ / ____ / ____ | ____ : ____ | ________________ | ________ | ________ | ____________________________ |
| ____ / ____ / ____ | ____ : ____ | ________________ | ________ | ________ | ____________________________ |
| ____ / ____ / ____ | ____ : ____ | ________________ | ________ | ________ | ____________________________ |
| ____ / ____ / ____ | ____ : ____ | ________________ | ________ | ________ | ____________________________ |
| ____ / ____ / ____ | ____ : ____ | ________________ | ________ | ________ | ____________________________ |
| ____ / ____ / ____ | ____ : ____ | ________________ | ________ | ________ | ____________________________ |
| ____ / ____ / ____ | ____ : ____ | ________________ | ________ | ________ | ____________________________ |
Minimum viable tracking
If you only track 3 things: date/time, dose, and site. Add one short note when anything changes.
When your dose changes
Log it as a new entry and note “dose change per Rx” so it’s searchable later.
Educational only — not medical advice. This template is for logging, not prescribing.