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INSULIN

INJECTION
for addressograph plate

Instructions: Use this tool to help you rotate the sites where you give yourself insulin. Write down the date
and time next to the site when you use it.

Injection Sites
________ X

X
X
X

________ X

________ X

_______
_______
_______

________ X
________ X

_______ X

________ X

X
________ X
X
________X
X
________ X
X
________ X X

_______
_______
_______

_______
_______
_______
_______

X
______ X
______ X
______ X

_______

X
______ X
______ X
______ X
______

X
X
X

______

X ______
X ______
X ______
X ______

X ______
X ______
X ______
X ______

2009 American Diabetes

Assn: Last Revised 5/11/12

________ X
________ X

X
X

_______
_______

Diabetes Education:
Tool - D