1
2
3
Treatment
Date
Time
Day
Number
/
:
/
:
/
:
/
:
/
:
4
5
Pen Volume
Prescribed
Dose
450 IU/0.75 mL
450 IU
450 IU
450 IU
450 IU
450 IU
6
7
Dose Feedback Window
Amount Displayed After Injection
Amount Set
to Inject
if "0",
injection complete
if "0",
injection complete
if "0",
injection complete
if "0",
injection complete
if "0",
injection complete
8
if not "0", need second injection
Inject this amount ...........using new pen
if not "0", need second injection
Inject this amount ...........using new pen
if not "0", need second injection
Inject this amount ...........using new pen
if not "0", need second injection
Inject this amount ...........using new pen
if not "0", need second injection
Inject this amount ...........using new pen
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