Submit Your Blood Pressure Readings - Northiam and Broad Oak Surgery

You can submit your blood pressure readings online using the form below. When taking your blood pressure:

Please check your blood pressure readings for 3-7 days in total
Do not check your blood pressure within 30 minutes after exercising or smoking
Please check your blood pressure in a siting position

Blood Pressure Readings

Basic details

NHS Number

You will need your NHS number. If you do not know your NHS number there is an online service which will help you find it. Click Here.

Name

First Middle Last

Date of Birth

Date Optional

Time

Systolic Optional

Please enter a number from 1 to 200.

Diastolic Optional

Please enter a number from 1 to 200.

Date Optional

Time

Systolic Optional

Please enter a number from 1 to 200.

Diastolic Optional

Please enter a number from 1 to 200.

Date Optional

Time

Systolic Optional

Please enter a number from 1 to 200.

Diastolic Optional

Please enter a number from 1 to 200.

Date Optional

Time

Systolic Optional

Please enter a number from 1 to 200.

Diastolic Optional

Please enter a number from 1 to 200.

Date Optional

Time

Systolic Optional

Please enter a number from 1 to 200.

Diastolic Optional

Please enter a number from 1 to 200.

Date Optional

Time

Systolic Optional

Please enter a number from 1 to 200.

Diastolic Optional

Please enter a number from 1 to 200.

Date Optional

Time

Systolic Optional

Please enter a number from 1 to 200.

Diastolic Optional

Please enter a number from 1 to 200.

Notes/Comments Optional

Weight Optional

Weekly alcohol intake (units) Optional

Smoking Status

Non-Smoker Optional

Smoker Optional

If you are a smoker, how many cigarettes do you smoke a day? Optional