Has a patient ever tried to tell you what their blood sugars were, but you really had no idea what was going on? 
Has a client ever showed you blood sugar results on a glucometer — but the time wasn’t set and you had no idea if the results were fasting, after a meal, before a meal or DURING a meal? 

This is a one page form that can be used to track blood sugars at different times of day – fasting, before breakfast, after breakfast, before lunch, after lunch, before dinner, after dinner & bed time. No matter what time your patient checks blood sugar, it can be recorded in the right spot so that the trends and results can be properly evaluated.Having a month worth of results on one page can be very helpful for identifying trends and patterns. Form can be customized with your office information / contact information. Section for instructions and goals can be customized for your practice and/or for each patient. Information provided on highlighting high & low blood sugars for further trend identification. 

This form can also be used in patient education – to explain that blood sugar results are expected to be different depending on when it is checked AND that timing of blood sugar monitoring is important. 

I’ve used this form in private practice and it is really helpful in assessing blood sugar control and in helping patients to track and understand their blood sugar results. 

Form is in word format – can be updated with your brand colors and logo if desired. 

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