Glucose Testing Log printable pdf download

Glucose Testing Log

GLUCOSE TESTING LOG

ACTION REQUIRED: PLEASE FILL OUT YOUR GLUCOSE LOG AND DELIVER TO YOUR DOCTOR.

Your blood glucose monitor stores 300 of your previous test results. Please look at the past month and write

them down on the Glucose Testing Log or print them out. The numbers down the left-hand side of this log sheet

represent the days of the month. Next to each day of the month, please record all of your blood sugar test results

for that day. Please record the number that you see on the screen of your blood glucose monitor. For example, if

your monitor says “130,” please write the number “130” in the appropriate place on the log sheet.

Please be sure to fill the log in completely and deliver it to your

doctor.

Name:____________________________

DOB ____/____/____

Month_______ Year__________

First Name / Last Name

RESULTS

Test 1

Test 2

Test 3

Test 4

Test 5

Test 6

Day

Test 7

Test 8

Comments

(Optional)

GTL 2.1 052815

Glucose Testing Log