Blood Pressure Review

If you have been advised by the surgery to submit your blood pressure readings on a regular basis please use this form.

Please provide a minimum of 28 readings (14 morning readings and 14 evening readings).

Please visit the following informative websites pages:

How to measure your blood pressure at home – Blood Pressure UK

Information on monitoring BP at home – Blood Pressure UK

Please ensure you check your junk email folder for a reply.

If your message is urgent, please call the practice on 01827 69283. This inbox is not monitored out of hours when the Practice is closed (between 18:30 and 08:00 or at weekends), if you need urgent assistance while we are closed, please call 111 or in an emergency dial 999.

Blood Pressure Review (2 readings)

Section

About You

Smoking status

Your Blood Pressure

Please submit 2 readings for both morning and evening.

For each blood pressure recording provided, at least two consecutive measurements should be taken, at least one minute apart.

Day 1

Please use this date format: DD/MM/YYYY.
1st Morning Measurement
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2nd Morning Measurement
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1st Evening Measurement
/
2nd Evening Measurement
/

Day 2

Please use this date format: DD/MM/YYYY.
1st Morning Measurement
/
2nd Morning Measurement
/
1st Evening Measurement
/
2nd Evening Measurement
/

Day 3

Please use this date format: DD/MM/YYYY.
1st Morning Measurement
/
2nd Morning Measurement
/
1st Evening Measurement
/
2nd Evening Measurement
/

Day 4

Please use this date format: DD/MM/YYYY.
1st Morning Measurement
/
2nd Morning Measurement
/
1st Evening Measurement
/
2nd Evening Measurement
/

Day 5

Please use this date format: DD/MM/YYYY.
1st Morning Measurement
/
2nd Morning Measurement
/
1st Evening Measurement
/
2nd Evening Measurement
/

Day 6

Please use this date format: DD/MM/YYYY.
1st Morning Measurement
/
2nd Morning Measurement
/
1st Evening Measurement
/
2nd Evening Measurement
/

Day 7

Please use this date format: DD/MM/YYYY.
1st Morning Measurement
/
2nd Morning Measurement
/
1st Evening Measurement
/
2nd Evening Measurement
/

Average Blood Pressure

This is automatically calculated for internal use only. Averages do not include day 1.

Morning Measurement

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Evening Measurement
/

Overall Average Blood Pressure

This is automatically calculated for internal use only. Averages do not include day 1.

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