Blood pressure

(single reading)

Please only use this form if requested by the practice

Blood Pressure (single reading)

Blood Pressure (single reading)

Only fill in this form if you have been asked by the practice to do so.

Our records indicate that your blood pressure is either high or has not been recorded recently. Please check your BP at a pharmacy or via self-check at either practice.
If you have been advised by the surgery to submit your information, please complete the information below.

Contact information

Your details.
Address
Town
County
Postcode

Your blood pressure reading is:

systolic
diastolic

Do not continue filling in this form.

Your blood pressure is dangerously high. Please contact the practice or Click here to call 111

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