Blood Pressure Review If you have been advised by the surgery to submit your blood pressure readings on a regular basis please use this form. Patient Instructions: 1. In the morning, ensure that you are rested and have taken no exercise in the last 30 minutes. 2. Then sit in a chair comfortably upright with your arm supported on a table beside you, with both feet on the ground. 3. Put the cuff on your upper arm (5cm above your elbow) resting on the table, the cuff should be roughly at the level of your heart. 4. Press the on/start button on the BP monitor and take two readings at least 1 minute apart. 5. Record the readings below with your pulse rate and any comments. 6. Repeat that evening & for a total of 7 days using alternate arms. Then return this diary (& BP monitor if borrowed) to the surgery.YOUR DETAILSName First Last Date of Birth DD slash MM slash YYYY Contact NumberEmail Date of first reading taken DD slash MM slash YYYY Smoking Status Smoker Never smoked Ex-smoker YOUR BLOODS PRESSURE RESULTSPlease provide a minimum of one blood pressure reading, up to a maximum of seven.Day 1 date DD slash MM slash YYYY Morning MeasurementSystolic "Higher" Diastolic "Lower" Heart Rate Evening MeasurementSystolic "Higher" Diastolic "Lower" Heart Rate Day-2 date DD slash MM slash YYYY Morning MeasurementSystolic "Higher" Diastolic "Lower" Heart Rate Evening MeasurementSystolic "Higher" Diastolic "Lower" Heart Rate Day 3 date DD slash MM slash YYYY Morning MeasurementSystolic "Higher" Diastolic "Lower" Heart Rate Evening MeasurementSystolic "Higher" Diastolic "Lower" Heart Rate Day 4 date DD slash MM slash YYYY Morning MeasurementSystolic "Higher" Diastolic "Lower" Heart Rate Systolic "Higher" Diastolic "Lower" Heart Rate Day 5 date DD slash MM slash YYYY Morning MeasurementSystolic "Higher" Diastolic "Lower" Heart Rate Evening MeasurementSystolic "Higher" Diastolic "Lower" Heart Rate Day 6 date DD slash MM slash YYYY Morning MeasurementSystolic "Higher" Diastolic "Lower" Heart Rate Evening MeasurementSystolic "Higher" Diastolic "Lower" Heart Rate Day 7 date DD slash MM slash YYYY Morning MeasurementSystolic "Higher" Diastolic "Lower" Heart Rate Evening MeasurementSystolic "Higher" Diastolic "Lower" Heart Rate Average Blood PressureThis is automatically calculated for internal use only. Morning MeasurementSystolic "Higher" Diastolic "Lower" Heart Rate Evening MeasurementSystolic "Higher" Diastolic "Lower" Heart Rate Any additional comments Optional