I trace it on the paper but instead of tissue paper I use the thin paper that Dr's use to cover their exam tables. I like that it doesn't have folds in it and I can pull off as much or little as I need. I was asking the Dr about the roll of paper hoping he would let me buy a roll & he generosly said no need to buy it and he gave me a whole roll!! :) It is a little heavier than the tissue paper but it works fine for me.