BWS Diabetes Review Questionnaire

Last Updated: 12/05/2021

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Diabetes Review

This questionnaire is for a routine review of your symptoms. If you are experiencing chest pain, severe shortness of breath or other concerning symptoms, please follow your care plan (if you have one) or ring your GP or 999 immediately.

Home blood pressure recordings

Please complete this section if you have a blood pressure monitor at home. Otherwise, please leave this blank and skip to next section. For instruction on how to take your blood pressure at home, please follow this link ---

Lifestyle - Alcohol

Lifestyle - Smoking

Lifestyle - activity and diet

Further Questions