Submit home measurements

Submit your blood pressure, heart rate, glucose values or other measurements from the past few days here.

Name

E-mail

Date of birth

Height(cm)

Weight (kg)

Submit blood pressure and heart rate

Enter the values exactly as they appear on your blood pressure monitor. If you are unsure, or if the values are very different from usual, please contact the practice. .

Blood pressure measurements

Measurement date

Systolic pressure

Diastolic pressure

Heart rate

Comment

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Submit glucose values

Enter your glucose values measured at home here. Enter the value in mmol/L as shown on your glucose meter. For each measurement, include the date, time, and whether the value was measured fasting, before or after a meal.

Glucose values

Measurement date

Time

Glucose value

Moment of measurement

Comment

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