{"id":1348,"date":"2018-05-02T19:30:54","date_gmt":"2018-05-02T18:30:54","guid":{"rendered":"http:\/\/www.ossettsurgery.nhs.uk\/?page_id=1348"},"modified":"2019-08-04T18:04:06","modified_gmt":"2019-08-04T17:04:06","slug":"blood-pressure-review-form","status":"publish","type":"page","link":"https:\/\/www.ossettsurgery.nhs.uk\/your-record\/health-review-forms\/blood-pressure-review-form\/","title":{"rendered":"Blood Pressure Review Form"},"content":{"rendered":"<link rel='stylesheet' id='formidable-css' href='https:\/\/www.ossettsurgery.nhs.uk\/wp-content\/plugins\/formidable\/css\/formidableforms.css?ver=4271745' media='all' \/>\n<div class=\"frm_forms  with_frm_style frm_style_big_text\" id=\"frm_form_14_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_hnlsj62\"  >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">Blood Pressure Review<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"14\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_14\" id=\"frm_hide_fields_14\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"hnlsj62\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_14\" name=\"frm_submit_entry_14\" value=\"985a635c61\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/pages\/1348\" \/><div id=\"frm_field_278_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_first frm_half\">\r\n    <label for=\"field_xu1tj62\" class=\"frm_primary_label\">First Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_xu1tj62\" name=\"item_meta[278]\" value=\"\"  data-reqmsg=\"First Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_279_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_xt7az62\" class=\"frm_primary_label\">Last Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_xt7az62\" name=\"item_meta[279]\" value=\"\"  data-reqmsg=\"Last Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_280_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_ppbxb62\" class=\"frm_primary_label\">Email\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_ppbxb62\" name=\"item_meta[280]\" value=\"\"  data-reqmsg=\"Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_281_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_first frm_half\">\r\n    <label for=\"field_w1eya62\" class=\"frm_primary_label\">Date of birth\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_w1eya62\" name=\"item_meta[281]\" value=\"\"  data-frmmask=\"99\/99\/9999\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Date of birth cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\" pattern=\"\\d\\d\\\/\\d\\d\\\/\\d\\d\\d\\d$\"   aria-describedby=\"frm_desc_field_w1eya62\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_w1eya62\">Please use format day\/month\/year e.g. 06\/09\/1978<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_282_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_spq8l42\" class=\"frm_primary_label\">Phone Number\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_spq8l42\" name=\"item_meta[282]\" value=\"\"  data-reqmsg=\"Phone Number cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_283_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Smoking Status<\/h3>\r\n\r\n\r\n<div id=\"frm_field_284_container\" class=\"frm_form_field form-field  frm_top_container horizontal_radio\">\r\n    <label for=\"field_kuh1f\" class=\"frm_primary_label\">What is your smoking status?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_284-283-0\"><label for=\"field_kuh1f-0\">\t\t<input type=\"radio\" name=\"item_meta[284]\" id=\"field_kuh1f-0\" value=\"Smoker\"\n\t\t   data-sectionid=\"283\" data-invmsg=\"What is your smoking status? is invalid\" aria-invalid=\"false\"  \/> Smoker<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_284-283-1\"><label for=\"field_kuh1f-1\">\t\t<input type=\"radio\" name=\"item_meta[284]\" id=\"field_kuh1f-1\" value=\"Never smoked\"\n\t\t   data-sectionid=\"283\" data-invmsg=\"What is your smoking status? is invalid\" aria-invalid=\"false\"  \/> Never smoked<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_284-283-2\"><label for=\"field_kuh1f-2\">\t\t<input type=\"radio\" name=\"item_meta[284]\" id=\"field_kuh1f-2\" value=\"Ex-smoker\"\n\t\t   data-sectionid=\"283\" data-invmsg=\"What is your smoking status? is invalid\" aria-invalid=\"false\"  \/> Ex-smoker<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_285_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_2v3cu\" class=\"frm_primary_label\">How many do you smoke each day?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_2v3cu\" name=\"item_meta[285]\" value=\"\"  data-sectionid=\"283\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_286_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_mfuwz\" class=\"frm_primary_label\">When did you give up smoking?\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_mfuwz\" name=\"item_meta[286]\" value=\"\"  data-sectionid=\"283\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_288_container\" class=\"frm_form_field  frm_html_container form-field\">\n<h2>Your Blood Pressure<\/h2>\n<p>Please provide a minimum of one day blood pressure readings, up to a maximum of seven days. Take a readings in the morning and in the evening of each day.<\/p><\/div>\n<div id=\"frm_field_289_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Day 1<\/h3>\r\n\r\n\r\n<div id=\"frm_field_290_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_first frm_third\">\r\n    <label for=\"field_mpytc\" class=\"frm_primary_label\">Date\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_mpytc\" name=\"item_meta[290]\" value=\"\"  data-sectionid=\"289\" maxlength=\"10\" data-reqmsg=\"Date cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_291_container\" class=\"frm_form_field  frm_html_container form-field\"><b>Readings in the Morning<\/b><\/div>\n<div id=\"frm_field_292_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_first frm_third\">\r\n    <label for=\"field_25lzd\" class=\"frm_primary_label\">Heart Rate morning\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_25lzd\" name=\"item_meta[292]\" value=\"\"  data-sectionid=\"289\" data-reqmsg=\"Heart Rate morning cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_293_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_third\">\r\n    <label for=\"field_2blp9\" class=\"frm_primary_label\">Systolic morning\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_2blp9\" name=\"item_meta[293]\" value=\"\"  data-sectionid=\"289\" data-reqmsg=\"Systolic morning cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_294_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_third\">\r\n    <label for=\"field_kl59s\" class=\"frm_primary_label\">Diastolic morning\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_kl59s\" name=\"item_meta[294]\" value=\"\"  data-sectionid=\"289\" data-reqmsg=\"Diastolic morning cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_295_container\" class=\"frm_form_field  frm_html_container form-field\"><b>Readings in the Evening<\/b><\/div>\n<div id=\"frm_field_296_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_first frm_third\">\r\n    <label for=\"field_7nbad\" class=\"frm_primary_label\">Heart Rate evening\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_7nbad\" name=\"item_meta[296]\" value=\"\"  data-sectionid=\"289\" data-reqmsg=\"Heart Rate evening cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_297_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_third\">\r\n    <label for=\"field_og52y\" class=\"frm_primary_label\">Systolic evening\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_og52y\" name=\"item_meta[297]\" value=\"\"  data-sectionid=\"289\" data-reqmsg=\"Systolic evening cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_298_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_third\">\r\n    <label for=\"field_jr4wo\" class=\"frm_primary_label\">Diastolic evening\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_jr4wo\" name=\"item_meta[298]\" value=\"\"  data-sectionid=\"289\" data-reqmsg=\"Diastolic evening cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_300_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Day 2<\/h3>\r\n\r\n\r\n<div id=\"frm_field_301_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_w1sdv\" class=\"frm_primary_label\">Date\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_w1sdv\" name=\"item_meta[301]\" value=\"\"  data-sectionid=\"300\" maxlength=\"10\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_302_container\" class=\"frm_form_field  frm_html_container form-field\"><b>Readings in the Morning<\/b><\/div>\n<div id=\"frm_field_303_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_6llpk\" class=\"frm_primary_label\">Heart Rate morning\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_6llpk\" name=\"item_meta[303]\" value=\"\"  data-sectionid=\"300\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_304_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_a28vq\" class=\"frm_primary_label\">Systolic morning\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_a28vq\" name=\"item_meta[304]\" value=\"\"  data-sectionid=\"300\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_305_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_7w2zm\" class=\"frm_primary_label\">Diastolic morning\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_7w2zm\" name=\"item_meta[305]\" value=\"\"  data-sectionid=\"300\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_306_container\" class=\"frm_form_field  frm_html_container form-field\"><b>Readings in the Evening<\/b><\/div>\n<div id=\"frm_field_307_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_q7m6r\" class=\"frm_primary_label\">Heart Rate evening\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_q7m6r\" name=\"item_meta[307]\" value=\"\"  data-sectionid=\"300\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_308_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_fafni\" class=\"frm_primary_label\">Systolic evening\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_fafni\" name=\"item_meta[308]\" value=\"\"  data-sectionid=\"300\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_309_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_lj18t\" class=\"frm_primary_label\">Diastolic evening\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_lj18t\" name=\"item_meta[309]\" value=\"\"  data-sectionid=\"300\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_311_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Day 3<\/h3>\r\n\r\n\r\n<div id=\"frm_field_312_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_8iyrq\" class=\"frm_primary_label\">Date\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_8iyrq\" name=\"item_meta[312]\" value=\"\"  data-sectionid=\"311\" maxlength=\"10\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_313_container\" class=\"frm_form_field  frm_html_container form-field\"><b>Readings in the Morning<\/b><\/div>\n<div id=\"frm_field_314_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_ylsoy\" class=\"frm_primary_label\">Heart Rate morning\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_ylsoy\" name=\"item_meta[314]\" value=\"\"  data-sectionid=\"311\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_315_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_hpj10\" class=\"frm_primary_label\">Systolic morning\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_hpj10\" name=\"item_meta[315]\" value=\"\"  data-sectionid=\"311\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_316_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_309p5\" class=\"frm_primary_label\">Diastolic morning\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_309p5\" name=\"item_meta[316]\" value=\"\"  data-sectionid=\"311\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_317_container\" class=\"frm_form_field  frm_html_container form-field\"><b>Readings in the Evening<\/b><\/div>\n<div id=\"frm_field_318_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_at9l8\" class=\"frm_primary_label\">Heart Rate evening\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_at9l8\" name=\"item_meta[318]\" value=\"\"  data-sectionid=\"311\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_319_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_3q3g2\" class=\"frm_primary_label\">Systolic evening\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_3q3g2\" name=\"item_meta[319]\" value=\"\"  data-sectionid=\"311\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_320_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_lhm4a\" class=\"frm_primary_label\">Diastolic evening\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_lhm4a\" name=\"item_meta[320]\" value=\"\"  data-sectionid=\"311\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_322_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Day 4<\/h3>\r\n\r\n\r\n<div id=\"frm_field_323_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_rbthi\" class=\"frm_primary_label\">Date\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_rbthi\" name=\"item_meta[323]\" value=\"\"  data-sectionid=\"322\" maxlength=\"10\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_324_container\" class=\"frm_form_field  frm_html_container form-field\"><b>Readings in the Morning<\/b><\/div>\n<div id=\"frm_field_325_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_pjel9\" class=\"frm_primary_label\">Heart Rate morning\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_pjel9\" name=\"item_meta[325]\" value=\"\"  data-sectionid=\"322\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_326_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_nxp30\" class=\"frm_primary_label\">Systolic morning\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_nxp30\" name=\"item_meta[326]\" value=\"\"  data-sectionid=\"322\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_327_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_dav1p\" class=\"frm_primary_label\">Diastolic morning\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_dav1p\" name=\"item_meta[327]\" value=\"\"  data-sectionid=\"322\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_328_container\" class=\"frm_form_field  frm_html_container form-field\"><b>Readings in the Evening<\/b><\/div>\n<div id=\"frm_field_329_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_kmeij\" class=\"frm_primary_label\">Heart Rate evening\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_kmeij\" name=\"item_meta[329]\" value=\"\"  data-sectionid=\"322\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_330_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_z7hwc\" class=\"frm_primary_label\">Systolic evening\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_z7hwc\" name=\"item_meta[330]\" value=\"\"  data-sectionid=\"322\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_331_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_b4d2i\" class=\"frm_primary_label\">Diastolic evening\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_b4d2i\" name=\"item_meta[331]\" value=\"\"  data-sectionid=\"322\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_333_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Day 5<\/h3>\r\n\r\n\r\n<div id=\"frm_field_334_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_ienoz\" class=\"frm_primary_label\">Date\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_ienoz\" name=\"item_meta[334]\" value=\"\"  data-sectionid=\"333\" maxlength=\"10\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_335_container\" class=\"frm_form_field  frm_html_container form-field\"><b>Readings in the Morning<\/b><\/div>\n<div id=\"frm_field_336_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_g3hiy\" class=\"frm_primary_label\">Heart Rate morning\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_g3hiy\" name=\"item_meta[336]\" value=\"\"  data-sectionid=\"333\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_337_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_b8tnp\" class=\"frm_primary_label\">Systolic morning\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_b8tnp\" name=\"item_meta[337]\" value=\"\"  data-sectionid=\"333\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_338_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_7g9ll\" class=\"frm_primary_label\">Diastolic morning\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_7g9ll\" name=\"item_meta[338]\" value=\"\"  data-sectionid=\"333\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_339_container\" class=\"frm_form_field  frm_html_container form-field\"><b>Readings in the Evening<\/b><\/div>\n<div id=\"frm_field_340_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_ya7qq\" class=\"frm_primary_label\">Heart Rate evening\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_ya7qq\" name=\"item_meta[340]\" value=\"\"  data-sectionid=\"333\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_341_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_m7rf0\" class=\"frm_primary_label\">Systolic evening\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_m7rf0\" name=\"item_meta[341]\" value=\"\"  data-sectionid=\"333\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_342_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_b1bh2\" class=\"frm_primary_label\">Diastolic evening\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_b1bh2\" name=\"item_meta[342]\" value=\"\"  data-sectionid=\"333\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_344_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Day 6<\/h3>\r\n\r\n\r\n<div id=\"frm_field_345_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_7qvip\" class=\"frm_primary_label\">Date\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_7qvip\" name=\"item_meta[345]\" value=\"\"  data-sectionid=\"344\" maxlength=\"10\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_346_container\" class=\"frm_form_field  frm_html_container form-field\"><b>Readings in the Morning<\/b><\/div>\n<div id=\"frm_field_347_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_77h6u\" class=\"frm_primary_label\">Heart Rate morning\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_77h6u\" name=\"item_meta[347]\" value=\"\"  data-sectionid=\"344\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_348_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_9ogny\" class=\"frm_primary_label\">Systolic morning\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_9ogny\" name=\"item_meta[348]\" value=\"\"  data-sectionid=\"344\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_349_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_e4a04\" class=\"frm_primary_label\">Diastolic morning\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_e4a04\" name=\"item_meta[349]\" value=\"\"  data-sectionid=\"344\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_350_container\" class=\"frm_form_field  frm_html_container form-field\"><b>Readings in the Evening<\/b><\/div>\n<div id=\"frm_field_351_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_awd7g\" class=\"frm_primary_label\">Heart Rate evening\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_awd7g\" name=\"item_meta[351]\" value=\"\"  data-sectionid=\"344\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_352_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_2oheg\" class=\"frm_primary_label\">Systolic evening\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_2oheg\" name=\"item_meta[352]\" value=\"\"  data-sectionid=\"344\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_353_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_elz59\" class=\"frm_primary_label\">Diastolic evening\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_elz59\" name=\"item_meta[353]\" value=\"\"  data-sectionid=\"344\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_355_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Day 7<\/h3>\r\n\r\n\r\n<div id=\"frm_field_356_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_lf87p\" class=\"frm_primary_label\">Date\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_lf87p\" name=\"item_meta[356]\" value=\"\"  data-sectionid=\"355\" maxlength=\"10\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_357_container\" class=\"frm_form_field  frm_html_container form-field\"><b>Readings in the Morning<\/b><\/div>\n<div id=\"frm_field_358_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_lsky9\" class=\"frm_primary_label\">Heart Rate morning\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_lsky9\" name=\"item_meta[358]\" value=\"\"  data-sectionid=\"355\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_359_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_mh0mn\" class=\"frm_primary_label\">Systolic morning\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_mh0mn\" name=\"item_meta[359]\" value=\"\"  data-sectionid=\"355\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_360_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_faa2\" class=\"frm_primary_label\">Diastolic morning\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_faa2\" name=\"item_meta[360]\" value=\"\"  data-sectionid=\"355\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_361_container\" class=\"frm_form_field  frm_html_container form-field\"><b>Readings in the Evening<\/b><\/div>\n<div id=\"frm_field_362_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_sdzju\" class=\"frm_primary_label\">Heart Rate evening\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_sdzju\" name=\"item_meta[362]\" value=\"\"  data-sectionid=\"355\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_363_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_eq8mv\" class=\"frm_primary_label\">Systolic evening\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_eq8mv\" name=\"item_meta[363]\" value=\"\"  data-sectionid=\"355\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_364_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_vrc3l\" class=\"frm_primary_label\">Diastolic evening\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_vrc3l\" name=\"item_meta[364]\" value=\"\"  data-sectionid=\"355\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"1000\" step=\"1\"\/>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_366_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Privacy Policy<\/h3>\r\n\r\n\r\n<div id=\"frm_field_367_container\" class=\"frm_form_field  frm_html_container form-field\">This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our <a href=\"https:\/\/www.ossettsurgery.nhs.uk\/about-us\/practice-policies\/patient-record\/how-we-use-your-data\/privacy-policy\/\" target=\"_blank\">Privacy Policy<\/a> to discover how we protect and manage your submitted data.<\/div>\n<div id=\"frm_field_368_container\" class=\"frm_form_field form-field  frm_required_field frm_inline_container vertical_radio\">\r\n    <label for=\"field_1hylz\" class=\"frm_primary_label\"> \r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_368-366-0\"><label for=\"field_1hylz-0\"><input type=\"checkbox\" name=\"item_meta[368][]\" id=\"field_1hylz-0\" value=\"I consent to the practice collecting and storing my data from this form.\"  data-sectionid=\"366\" data-reqmsg=\"We need your consent to proceed. Please tick the box to consent.\" data-invmsg=\"  is invalid\" aria-invalid=\"false\"   aria-required=\"true\"  \/> I consent to the practice collecting and storing my data from this form.<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t<input name=\"frm_state\" type=\"hidden\" value=\"YSMH\/ZlbtJNl6RUzuRUGMfnv+OyLR5OGnxe0jnK2Gcc=\" \/><div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"   formnovalidate=\"formnovalidate\">Send<\/button>\r\n\r\n<\/div><\/div>\n<\/fieldset>\n<\/div>\n<\/form>\n<\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":6577921,"featured_media":2496,"parent":1340,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","_uag_custom_page_level_css":"","footnotes":"","_links_to":"","_links_to_target":""},"acf":[],"uagb_featured_image_src":{"full":["https:\/\/www.ossettsurgery.nhs.uk\/wp-content\/uploads\/2019\/02\/arms-black-and-white-blood-pressure-968244.jpg",1600,1837,false],"thumbnail":["https:\/\/www.ossettsurgery.nhs.uk\/wp-content\/uploads\/2019\/02\/arms-black-and-white-blood-pressure-968244-150x150.jpg",150,150,true],"medium":["https:\/\/www.ossettsurgery.nhs.uk\/wp-content\/uploads\/2019\/02\/arms-black-and-white-blood-pressure-968244-261x300.jpg",261,300,true],"medium_large":["https:\/\/www.ossettsurgery.nhs.uk\/wp-content\/uploads\/2019\/02\/arms-black-and-white-blood-pressure-968244-768x882.jpg",768,882,true],"large":["https:\/\/www.ossettsurgery.nhs.uk\/wp-content\/uploads\/2019\/02\/arms-black-and-white-blood-pressure-968244-892x1024.jpg",892,1024,true],"1536x1536":["https:\/\/www.ossettsurgery.nhs.uk\/wp-content\/uploads\/2019\/02\/arms-black-and-white-blood-pressure-968244.jpg",1338,1536,false],"2048x2048":["https:\/\/www.ossettsurgery.nhs.uk\/wp-content\/uploads\/2019\/02\/arms-black-and-white-blood-pressure-968244.jpg",1600,1837,false],"mailpoet_newsletter_max":["https:\/\/www.ossettsurgery.nhs.uk\/wp-content\/uploads\/2019\/02\/arms-black-and-white-blood-pressure-968244.jpg",1320,1516,false]},"uagb_author_info":{"display_name":"Editor","author_link":"https:\/\/www.ossettsurgery.nhs.uk\/author\/gary-genpra\/"},"uagb_comment_info":0,"uagb_excerpt":null,"publishpress_future_action":{"enabled":false,"date":"2024-05-04 21:02:10","action":"change-status","newStatus":"draft","terms":[],"taxonomy":""},"_links":{"self":[{"href":"https:\/\/www.ossettsurgery.nhs.uk\/wp-json\/wp\/v2\/pages\/1348"}],"collection":[{"href":"https:\/\/www.ossettsurgery.nhs.uk\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.ossettsurgery.nhs.uk\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.ossettsurgery.nhs.uk\/wp-json\/wp\/v2\/users\/6577921"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ossettsurgery.nhs.uk\/wp-json\/wp\/v2\/comments?post=1348"}],"version-history":[{"count":0,"href":"https:\/\/www.ossettsurgery.nhs.uk\/wp-json\/wp\/v2\/pages\/1348\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/www.ossettsurgery.nhs.uk\/wp-json\/wp\/v2\/pages\/1340"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.ossettsurgery.nhs.uk\/wp-json\/wp\/v2\/media\/2496"}],"wp:attachment":[{"href":"https:\/\/www.ossettsurgery.nhs.uk\/wp-json\/wp\/v2\/media?parent=1348"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}