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.

Instructions

For a list of validated monitors, visit bihsoc.org/bp-monitors or discuss with your pharmacy.

  • Before measuring your blood pressure ensure that you are rested and have not exercised in the last 30 minutes.
  • Then sit in a chair comfortably upright with your arm supported on a table beside you, with both feet on the ground.
  • Put the cuff on your upper arm (5cm above your elbow) resting on the table, the cuff should be roughly at the level of your heart.
  • Press the on/start button on the BP monitor and take two readings at least 1 minute apart.
  • Repeat this process twice during the day.
  • Record only the lowest reading done that day.
  • Repeat for a total of 7 days.
  • If you have not discussed your results or been contacted within 2 weeks, please contact your GP surgery.
Blood Pressure Review

About You

Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.
Smoking status

Your Blood Pressure

Please provide a minimum of one blood pressure reading, up to a maximum of seven.

Day 1

Please use this date format: DD/MM/YYYY.
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Day 2

Please use this date format: DD/MM/YYYY.
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Day 3

Please use this date format: DD/MM/YYYY.
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Day 4

Please use this date format: DD/MM/YYYY.
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Day 5

Please use this date format: DD/MM/YYYY.
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Day 6

Please use this date format: DD/MM/YYYY.
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Day 7

Please use this date format: DD/MM/YYYY.
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Average Blood Pressure

This is automatically calculated for internal use only.

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