Diabetic Blood Glucose Monitoring

If you have been advised by the surgery to submit a Diabetic Blood Glucose Monitoring Review please use this form.

Diabetic Blood Glucose Monitoring

Please complete the following over a one week period. We need a minimum of two readings per day. These need to be taken at alternate times each day and entered into the boxes below.

Day 1

Please use this date format: DD/MM/YYYY.

Day 2

Please use this date format: DD/MM/YYYY.

Day 3

Please use this date format: DD/MM/YYYY.

Day 4

Please use this date format: DD/MM/YYYY.

Day 5

Please use this date format: DD/MM/YYYY.

Day 6

Please use this date format: DD/MM/YYYY.

Day 7

Please use this date format: DD/MM/YYYY.