Download and print the form below. Once completed return it to the reception team at one of our practice sites. We will calculate the average blood pressure and contact you if further action is needed.
Before taking your blood pressure, please read the official guidance on how to measure your blood pressure correctly at BIHSOC: Home Blood Pressure Monitoring Explained
Record your blood pressure for 5 days in a row. On each day, record your blood pressure in the morning and in the evening. Morning means between 06:00 and noon and Evening means between 18:00 and midnight. On each occasion take at least 2 readings, leaving at least a minute between each. If the first two readings are very different, take 2 or 3 further readings. For each occasion, when taking more than one blood pressure reading, enter the lowest of the top (systolic) and lowest of the bottom (diastolic) reading onto the form.
For example, if on the morning of day one, you take 3 blood pressure readings, enter the lowest of the top number and the lowest of the bottom number as the blood pressure reading for that measurement.
148/88
152/84
136/90
In the example above the blood pressure to enter would be:
136/84
You don’t need to record your heart rate more than once, unless you have been asked to.