Home Blood Pressure Monitoring Form Page 2

Home Blood Pressure Monitoring Form

Forename:

Surname:

Date of Birth:

Dear Sir/Madam,

Please could you check your home blood pressure readings.

To check your blood pressure at home you need to take 2 readings each

morning and evening for 5-7 days. Sit down at a table, in a quiet

environment with your arm rested in front of you and take 2 readings the

second 1-2 minutes after the first.

To work out your blood pressure we ignore the first day’s readings and

take an average of the rest.

AM1

AM2

PM1

PM2

Day1

Discard today

readings

Day2

Day3

Day4

Day5

Day6

Day7

AVERAGE SYSTOLIC:

AVERAGE DIASTOLIC:

For Attention of Dr _________________

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Parent category: Medical