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Fills the date column where the template has one.
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Injection site rotation record
The Wegovy and Zepbound labels list the abdomen, thigh and upper arm as injection sites and say to rotate with each dose. This grid makes rotation visible at a glance.
| Site | Wk 1 | Wk 2 | Wk 3 | Wk 4 | Wk 5 | Wk 6 | Wk 7 | Wk 8 |
|---|---|---|---|---|---|---|---|---|
| Abdomen, left side | ||||||||
| Abdomen, right side | ||||||||
| Thigh, left front | ||||||||
| Thigh, right front | ||||||||
| Upper arm, left (back; needs another person) | ||||||||
| Upper arm, right (back; needs another person) |
Skip skin that is bruised, tender, red or hard. Mark a site you could not use with an X and write why in the notes.
Notes (bruising, leaks, site reactions)
The labels for Wegovy and Zepbound both say the same two things about where to inject: use the abdomen, thigh or upper arm, and rotate sites with each dose. The dose log has a column for the site, but a column is a list, and rotation is easier to see as a grid. This sheet is the grid.
How it works
Six rows: left and right abdomen, left and right front of thigh, and the back of the left and right upper arm. Eight columns, one per week. Each week, mark the box for the site you used. After a month the pattern is visible without reading anything: a column of ticks down one row means you have been using the same place, which is the thing rotation exists to prevent.
The upper-arm rows carry the Zepbound label's point that the back of the upper arm is a site for someone else to inject; most people using a pen on their own rotate between abdomen and thighs and leave those rows for weeks when help is available.
The X
If a site could not be used because the skin there was bruised, tender, red or hard, mark it with an X rather than skipping the box, and write why in the notes lines. A site that is repeatedly X'd is worth mentioning to your prescriber; so is a lump that does not settle. The side-effect diary is the place for the details, and the shot-day checklist has the skin check as one of its "during" items.
After eight weeks
Print another. The builder's start date is optional for this sheet, because the columns are week numbers rather than dates; if you want dates, write them under the week numbers by hand or use the dose log alongside. Injection technique by site, including why the abdomen and thigh are the usual self-injection choices, is covered at length on the FormBlends Guides site.
Sources
- Wegovy (semaglutide) prescribing information and instructions for use, DailyMed set id ee06186f-2aa3-4990-a760-757579d8f77b Accessed September 4, 2026.
- Zepbound (tirzepatide) prescribing information and instructions for use, DailyMed set id 487cd7e7-434c-4925-99fa-aa80b1cc776b Accessed September 4, 2026.
Canonical URL: https://formblendstools.com/templates/injection-site-rotation-record. Written by the FormBlends editorial team. This page is educational and is not medical advice; see the medical disclaimer.