Blood Pressure Review

It is recommended that all adults over 40 years of age have their blood pressure tested at least every 5 years so any potential problems can be detected early.

You can check your blood pressure without an appointment by using the self-service machine in the surgery. Alternatively, most pharmacies have a free blood pressure measuring service.

For Patients already diagnosed with high blood pressure:

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

For any other patient:

Please use form to submit a blood pressure reading to the practice.

We only need you to complete the Day 1 morning measurement along with the date that you measured your blood pressure.

Blood Pressure Review

About You

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

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.
Morning Measurement (or single Blood Pressure Reading)
/
Evening Measurement
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Day 2

Please use this date format: DD/MM/YYYY.
Morning Measurement
/
Evening Measurement
/

Day 3

Please use this date format: DD/MM/YYYY.
Morning Measurement
/
Evening Measurement
/

Day 4

Please use this date format: DD/MM/YYYY.
Morning Measurement
/
Evening Measurement
/

Day 5

Please use this date format: DD/MM/YYYY.
Morning Measurement
/
Evening Measurement
/

Day 6

Please use this date format: DD/MM/YYYY.
Morning Measurement
/
Evening Measurement
/

Day 7

Please use this date format: DD/MM/YYYY.
Morning Measurement
/
Evening Measurement
/

Average Blood Pressure

This is automatically calculated for internal use only.

Morning Measurement

/
Evening Measurement
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