Home Blood Pressure Monitoring

Your doctor has asked you to take some blood pressure readings at home
Make sure you are sitting down and relaxed
Take two readings at least one minute apart
Do the readings twice a day, ideally in the morning and evening
If you forget to take a reading just put a cross in the box

Last Updated: 21/12/2022

Patient data

You will be asked for persoanl information in order for us to indentify you

Full name *

Date of birth *

Day 1

Please enter your BP readings from day 1 (you should enter 2 readings, one taken in the AM and one taken in the PM) *

Day 2

Please enter your BP readings from day 2 (you should enter 2 readings, one taken in the AM and one taken in the PM) *

Day 3

Please enter your BP readings from day 3 (you should enter 2 readings, one taken in the AM and one taken in the PM) *

Day 4

Please enter your BP readings from day 4 (you should enter 2 readings, one taken in the AM and one taken in the PM) *

Day 5

Please enter your BP readings from day 5 (you should enter 2 readings, one taken in the AM and one taken in the PM) *

Day 6

Please enter your BP readings from day 6 (you should enter 2 readings, one taken in the AM and one taken in the PM) *

Day 7

Please enter your BP readings from day 7 (you should enter 2 readings, one taken in the AM and one taken in the PM) *

Further information

You will now be asked a series of health related questions

Do you smoke? *

Yes No

If you answered yes how many a day?

Do you drink alcohol? *

Yes No

If you answered yes how many units a week?

What is your height? *

What is your weight? *

How much exercise do you do each week? If none, please state *

Do you consent to the use of text messaging for general communications? *

Yes No

Do you consent to the use of text messaging for test results? *

Yes No

Please confirm your mobile number (by doing this you are confirming you have read our patient responsibility leaflet for the use of text messaging communications)

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Home Blood Pressure Monitoring

Further Information