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 your 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
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