Home Blood Pressure Monitoring (HBPM)

If you are asked to check and record your blood pressure at home to help your doctor/nurse confirm a diagnosis of hypertension (high blood pressure) then please either fill in the form below or click here to download a copy of our form to then bring into the surgery. 

Your doctor/nurse might have also asked you to fill in one of these forms to help them decide if you require further medication if you are already being treated for hypertension. 

Checking your own blood pressure

  • Make sure you are sitting comfortably with your arm supported and the cuff placed on your arm as you have been shown.
  • Check and record your blood pressure on this chart twice a day – in the morning and evening for 7 days. 
  • For each blood pressure recording, take two measurements at least 1 minute apart.  


  • Please return the chart to the surgery before your next appointment with the doctor/nurse so that the results can be available when you are seen. Or alternatively you can submit your complete form via the form below.
  • An average blood pressure will be established by discarding the first days recordings and using all the remaining 6 days recordings for the calculation.