HealthRX.com · Printable symptom log
Ozempic feet symptom log and questions for your prescriber
Use this sheet to record any foot symptoms while taking Ozempic, track when they happen with other reactions, and bring a clear written record to your prescriber or pharmacist.
Your Ozempic details
Write these exactly as they appear on your pharmacy label and chart.
Medicine name and strengthCopy from the pharmacy label
Day of the week your dose is dueWrite the day
Date your current dose started
Prescriber name and phone
Pharmacy name and phone
Foot symptom tracker
Record any change in feeling, color, swelling or skin as soon as you notice it.
| Date | Foot symptom | Where on foot | Other reactions | Shared with clinician |
|---|---|---|---|---|
Before your visit
- Bring the medicine pen or box with its label
- Note the date each dose change happened
- Write down any tingling, burning, aching or swelling you noticed
- Note any swelling of the face, lips or throat and when it happened
- Note nausea, vomiting, diarrhea or constipation and how often they occurred
- Confirm with your pharmacist which warnings are listed on your leaflet
- List every other medicine and supplement you take
Questions to ask
- Is Ozempic feet a diagnosis that appears in my medical record?
- Could any foot symptom in my log be related to my Ozempic dose?
- Which symptoms should I track in case they relate to fluid loss?
- Should my kidney function be checked during dose increases?
- What warning signs should I report to you right away?
- Who should I contact after office hours if a reaction starts?
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.