Blood Sugar Log
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1Geauga Family Physicians Blood Sugar Log
By recording your blood sugar readings and sharing them with your doctor, you can both get a better idea of
how your treatment plan is working and if it should be adjusted.
Blood Glucose Targets
Before Breakfast: 70 to 130 mg/dl
Week of _____/_____/_____ to _____/_____/_____
Two hours after meals: Below 180 mg/dl
My A1C level is _____ My A1C goal is ____
Patient’s Name: __________________________________________
______
Date of Birth: _____/_____/_______
Doctor’s Name: (___ Dr. Moritz) ( ___Dr. Urbancic) (___Dr. Carlson)
Geauga Family Physicians Contact Info: Phone (440) 286 – 6155
FAX (440) 286 – 6156
13221 Ravenna Road Suite 8 Chardon, OH 44024
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Parent category: Medical