Patient Home Blood Pressure Monitoring - Record Chart
INSTRUCTIONS:
Please note that you cannot save this form as work in progress.
Once you have pressed submit, the form will be emailed to the practice.
Please note that you will not receive any notification from your submission.
If we have any further concerns regarding your blood pressure we will contact you or if you have not heard from us within next 5 working days then please contact us.
Take all blood pressure reading while seated with you feet on the floor and legs uncrossed.
Ensure your arm is rested on a flat surface around chest level
Avoid measuring blood pressure after vigorous activity, exercise or directly after eating as this will increase the values
Take 3 measurements in the morning (at least 1 minute apart) and 3 in the evening (at least 1 minute apart)
Record the information in the table below and return to the Phoenix Family Care
Patient Home Blood Pressure Monitoring - Record Chart
Day ONE - Morning Readings
Day ONE - Evening Readings
Day TWO - Morning Readings
Date TWO - Evening Readings
Day THREE - Morning Readings
Day THREE - Evening Readings
Day FOUR - Morning Readings
Day FOUR - Evening Readings
Day FIVE - Morning Readings
Day FIVE - Evening Readings
Day SIX - Morning Readings
Day SIX - Evening Readings
Day SEVEN - Morning Readings
Day SEVEN - Evening Readings
Privacy Protection
We will use the information entered into this form only for the purposes of processing your enquiry and may be in touch with you in relation to the data submitted.
Information entered into this form is emailed directly to us and is processed by designated staff members. Issues raised in comments may be discussed between relevant members of staff
Phoenix Family Care works with other health and social care organisations to share information that will form part of your Integrated Care Record. The Integrated Care Record allows health and care professionals involved in your care to view your records to help them understand your needs and make the best decisions with you, and for you. Information we hold about you will be available, to read only, to other Health and care professionals in Coventry and Warwickshire, Birmingham and Solihull, and Herefordshire and Worcestershire when they are involved in your health or social care.
For more information on how your data is used on the Integrated Care Record and how to exercise your rights please see the full Privacy Notice or copy and paste this link https://www.happyhealthylives.uk/our-priorities/digital-transformation/integrated-care-record/privacy-notice/
This information is retained for up to 28 days.
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please use one of the alternative methods offered by our organisation.