Blood pressure readings

Which surgery are you registered at?

Smoking

Smoking status: *

Smoker

What do you mainly smoke?
How many cigarettes do you smoke in a day? *
How many cigars do you smoke in a day? *
Would you like to give up smoking? *

If you would like help or advice to stop smoking, please visit NHS Quit Smoking.

Ex smoker

What did you mainly smoke?
How many cigarettes did you smoke in a day? *
How many cigars did you smoke in a day? *

Your blood pressure

Please provide a minimum of 1 blood pressure reading, up to a maximum of 7 readings.

Day 1

Please use this date format: DD/MM/YYYY
Morning Measurement
Evening Measurement

Day 2

Please use this date format: DD/MM/YYYY
Morning Measurement
Evening Measurement

Day 3

Please use this date format: DD/MM/YYYY
Morning Measurement
Evening Measurement

Day 4

Please use this date format: DD/MM/YYYY
Morning Measurement
Evening Measurement

Day 5

Please use this date format: DD/MM/YYYY
Morning Measurement
Evening Measurement

Day 6

Please use this date format: DD/MM/YYYY
Morning Measurement
Evening Measurement

Day 7

Please use this date format: DD/MM/YYYY
Morning Measurement
Evening Measurement

Average blood pressure

This is automatically calculated for internal use only.

Morning Measurement

Evening Measurement
Terms and conditions *