Plenish › Free printable
GLP-1 doctor visit log
What should I bring to a GLP-1 doctor visit?
Bring a short record of what happened since your last visit: the date, dose and injection site of each shot, your weight readings, any side effects with how strong they felt and how long they lasted, a rough picture of what you ate, and your top three questions. This free two-page log has a section for each, ready to print.
US Letter · 2 pages · no sign-up, no email · Updated
What's on it
About you
Medication, current dose, start date, provider and your next visit, at the top where it's easy to find.
Shots
One row per dose: date, medication and dose, injection site, and anything worth noting.
Weight
Date, weight and notes, so a trend is visible at a glance.
Side effects
What you noticed in your own words, how strong it felt on a 1–5 scale, and how long it lasted.
A typical week of eating
Rough protein, fiber, water and meals for each day of one week.
Questions
Your top three questions, most important first, plus space for notes from the visit.
How to use it
- Print it right after a visit. Keep it with your medication so it's there when you need it.
- Add a row every time you take a dose. Writing the injection site down makes it easy to see where you went last.
- Write side effects down when you notice them, not from memory the day before. Your own words are fine.
- The night before your appointment, fill in one typical week of eating and write your top three questions.
- Bring it, or a photo of it. Use the last section for what you agreed on, so it's ready for next time.
Rather not use paper?
Let Plenish fill it in
Plenish keeps the same record from what you log in the app: doses and injection sites, weight, side effects and meals. When it's time for your appointment, export 30, 90 or 180 days as one PDF.
Free on iPhone and Android. No account, and your logs stay on your phone.
Questions
Is the log really free?
Yes. No sign-up and no email. Print as many copies as you like for yourself or the people you care for.
Does it work with my medication?
It works with any GLP-1 medication, weekly or daily, shot or pill. Write down whatever you take, at the dose your provider prescribed.
Can I fill it in on my phone or computer?
This version is made for printing and writing by hand. For a digital record, the Plenish app logs the same things and exports them as a PDF.
Will it tell me what to do about a side effect or my dose?
No. The log is a record of what you wrote down, to help you and your provider talk it through. Decisions about your treatment belong to you and your provider.
Can I share it?
Please do: share a link to this page so people always get the latest version.
Plenish is a tracking tool, not a medical device, and this log is not medical advice. Always follow your healthcare provider's guidance.