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Blood Pressure – Weekly Readings

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Step 1 of 3 - About You

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

Instructions:

  • Don't smoke, drink caffinated drinks or exercise 30 minutes before measuring your blood pressure (BP)
  • Ensure 5 minutes of quiet rest before taking your BP.
  • Sit with your back straight and supported, your feet flat on the floor and your legs uncrossed. Your arm should be supported on a flat surface with your upper arm at heart level. Don't take the measurement over clothes.
  • On each occasion take your blood pressure TWICE and submit the SECOND reading.
  • Record your blood pressure TWICE DAILY, ideally in the morning and the evening.
  • Record your blood pressure for A TOTAL OF SEVEN DAYS.

Personal Information

Name*
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Smoking Status
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