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.

About You

DD slash MM slash YYYY

Smoking Status

Do you smoke?

Blood Pressure (BP) Readings (1 to 5)

Add as many past readings as you are able. This will give your GP a better understanding of your blood pressure over time.
Date of Reading
Example: 18/06/2021
Time
:
Example: 13:45
Please enter a number from 50 to 250.
Please enter a number from 50 to 250.
Please enter a number from 20 to 200.
Please enter a number from 20 to 200.
Date of Reading
Example: 18/06/2021
Time
:
Example: 13:45
Please enter a number from 50 to 250.
Please enter a number from 50 to 250.
Please enter a number from 20 to 200.
Please enter a number from 20 to 200
Date of Reading
Example: 18/06/2021
Time
:
Example: 13:45
Please enter a number from 50 to 250.
Please enter a number from 50 to 250.
Please enter a number from 20 to 200.
Please enter a number from 20 to 200
Date of Reading
Example: 18/06/2021
Time
:
Example: 13:45
Please enter a number from 50 to 250.
Please enter a number from 50 to 250.
Please enter a number from 20 to 200.
Please enter a number from 20 to 200
Date of Reading
Example: 18/06/2021
Time
:
Example: 13:45
Please enter a number from 50 to 250.
Please enter a number from 50 to 250.
Please enter a number from 20 to 200.
Please enter a number from 20 to 200
Add more readings