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.

BP (Blood Pressure) Home Recording information

Please view our helpful video below from Dr Steven Bright, on home BP (Blood Pressure) recording:

Blood Pressure Review

About You

Please use this date format: DD/MM/YYYY.
Smoking status *
If you would like help to stop smoking, please see our Stop Smoking advice section

BMI

Please visit NHS: Body Mass Index Calculator to calculate your BMI. Enter your results in the box below.

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
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Evening Measurement
/

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
/

Average Blood Pressure Combined

Average Morning and Evening Measurements
/
*