Blood pressure readings

If you prefer you can print out and return this hard copy form to us >>

BP readings form 2024
Have you been asked to complete this form by a doctor or nurse at the Practice, or received a letter or text message asking you to fill it in?
Please don’t carry on filling out this form. This form should only be completed by patients who:

  • have been asked to do so by a doctor or nurse at the Practice
  • have been asked to do so via a letter or text message from the Practice

Please note a minimum of 5 days of blood pressure readings down on a piece of paper, following the instructions below. Then enter the readings into the form.

Hard copy forms are available at Reception if you prefer.

Please use format day/month/year e.g. 06/09/1978

Your blood pressure

  • Blood pressure monitors can be bought from pharmacies and online. There’s also a blood pressure monitor and scales in our waiting room if needed.
  • Take readings for at least five days
  • Take your blood pressure while sitting down
  • For each blood pressure reading, take two measurements at least 1 minute apart – enter the lowest
  • Record your blood pressure twice a day: once in the morning, once in the evening
  • Some blood pressure monitors may display in the format ‘140/80’ – the first number is the systolic reading and the last number is the diastolic reading

Average Readings

Day 1

Morning

Evening

Day 2

Morning

Evening

Day 3

Morning

Evening

Day 4

Morning

Evening

Day 5

Morning

Evening

Day 6

Morning

Evening

Day 7

Morning

Evening

Privacy Policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.