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    Form - Blood Pressure Record Sheet

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    Sep.01.2022
    Form - Blood Pressure Record Sheet

    Blood Pressure Record Sheet

    To take your blood pressure, you will need a blood pressure machine. You may be prescribed one, or you can buy a blood pressure machine (blood pressure monitor) at your clinic, drug store, or online. When choosing one, look for these features:
    • An automatic monitor that has an arm cuff.
    • A cuff that wraps snugly, but not too tightly, around your upper arm. You should be able to fit only one finger between your arm and the cuff.
    • A device that stores blood pressure reading results.
    • Do not choose a monitor that measures your blood pressure from your wrist or finger.
    Follow your health care provider's instructions for how to take your blood pressure. To use this form:
    • Get one reading in the morning (a.m.) before you take any medicines.
    • Get one reading in the evening (p.m.) before supper.
    • Take at least two readings with each blood pressure check. This makes sure the results are correct. Wait 1–2 minutes between measurements.
    • Write down the results in the spaces on this form.
    • Repeat this once a week, or as told by your health care provider.
    • A person checking his or her blood pressure. Make a follow-up appointment with your health care provider to discuss the results.

    Blood pressure log

    Date: _______________________
    • a.m. _____________________(1st reading) _____________________(2nd reading)
    • p.m. _____________________(1st reading) _____________________(2nd reading)

    Date: _______________________
    • a.m. _____________________(1st reading) _____________________(2nd reading)
    • p.m. _____________________(1st reading) _____________________(2nd reading)

    Date: _______________________
    • a.m. _____________________(1st reading) _____________________(2nd reading)
    • p.m. _____________________(1st reading) _____________________(2nd reading)

    Date: _______________________
    • a.m. _____________________(1st reading) _____________________(2nd reading)
    • p.m. _____________________(1st reading) _____________________(2nd reading)

    Date: _______________________
    • a.m. _____________________(1st reading) _____________________(2nd reading)
    • p.m. _____________________(1st reading) _____________________(2nd reading)

    This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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