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Assessment Form

Kindly complete the assessment form below so we can gather more information and provide a referral to a local clinic for the management of hypertension and additional services.

BPT HEART logo in red and blue underlined with a heart stethoscope around it

ATTENTION: A BLOOD PRESSURE READING HIGHER THAN 180/120 mm Hg IS A CRISIS. Make sure you are calm when taking your blood pressure. IF the bp reading is higher than 180/120, wait a few minutes and take blood pressure again. If it's still high, contact your doctor or health care provider immediately.

**Please give us 2 business days to get back to you with a referral.

Please contact Althea Green with any questions by calling 203-414-2159 or emailing her at Althea.Green@bridgeportct.gov

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