PepBloom

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Printable GLP-1 shot log

Print this blank log, or save it as a PDF, and fill in one row for each shot. Every box is blank for you to write in.

One row per shot: date, time, medicine, amount, site, weight and notes

Every box is blank, so you write in your own medicine and amount, the way your prescription label gives them.

Shot log

DateTimeMedicineAmountSiteWeightNotes

Worked example

A filled row might read: Nov 2, 8:00 AM, the medicine name from your pharmacy label, the amount written the way your label writes it, left thigh, your weight, and "felt fine".

Questions

What should I write in a shot log?

Copy the medicine name and the amount from your prescription label, in the unit it uses, so the log matches what you were told. Weight and notes are optional. Bring it to your next appointment.

Why write down the injection site?

So the next shot goes somewhere else. The Ozempic, Wegovy, Mounjaro and Zepbound labels each say to change the injection site with every shot.

How do I save it as a PDF?

Tap "Print or save as PDF". On a computer, pick Save as PDF as the printer. On iPhone, use Share in the print screen, then Save to Files. Only the sheet prints.

Sources

  1. Ozempic (semaglutide) prescribing information DailyMed
  2. Wegovy (semaglutide) prescribing information DailyMed
  3. Mounjaro (tirzepatide) prescribing information DailyMed
  4. Zepbound (tirzepatide) prescribing information DailyMed

Related

semaglutide (Ozempic, Wegovy) · tirzepatide (Mounjaro, Zepbound) · Injection site rotation chart · Printable side effect log

PepBloom does this automatically

Log each shot in a few taps, then share a PDF report with your doctor.

Coming soon on the App Store