Journey 2 Health

Journey 2 Health

Blood Pressure Monitoring Form
Name*

First NameLast Name
Date of Birth (for identification purposes)*

MonthDayYear
Date
Date & Time that BP was taken.*

MonthDayYear
Date
Hour MinutesAM/PM Option
Top #:*
Systolic BP is usually between 105 and 135
Bottom #:*
Diastolic BP is usually between 60 and 85
Heart Rate*
Heart Rate is usually between 60 and 100
If your blood pressure is too high or too low, please request an appointment so we can discuss your Journey 2 Health!
Additional Notes:
Should be Empty: