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Blood Sugar Test Booking Form
What Is Blood Sugar or Glucose?
Glucose is the type of sugar that the cells of the human body use as their main energy source. Your body breaks down the food you eat into glucose and other substances. Your liver stores extra glucose and can produce it at times when you are not eating. The glucose goes into your bloodstream, where a hormone called insulin helps bring glucose into your body’s cells. Too much glucose in the blood can be a sign of diabetes, a serious medical condition that can cause tissue and organ damage if it is not managed. Diabetes can develop if your body can’t make enough insulin or if your body’s cells have trouble accepting insulin.

Too little glucose in the blood is called hypoglycemia. Hypoglycemia is often caused by diabetes medication, but may also be due to health conditions unrelated to diabetes or to other medications.

Who should get testing?
You should consider getting a blood sugar test to screen you for elevated glucose if you are at a higher-than-average risk of diabetes. Risk factors for diabetes include:

Being 45 years of age or older
Being overweight or obese
Heart disease, high blood pressure, or high cholesterol
Prediabetes
Having family members with diabetes
A lack of physical activity
Polycystic ovarian syndrome

A blood sugar test should also be considered if you are experiencing symptoms of diabetes, including:

Frequent urination
Excessive hunger or thirst
Tingling or loss of feeling in the hands or feet
Blurred vision
An abnormal number of infections
Unexplained weight loss
Feeling very tired
Skin that is dry
Sores that don’t heal quickly
Feeling very tired
Your preferred appointment date: *
We will contact you to confirm the exact date and time.
Your preferred pharmacy: *
Full Name *
Date of Birth *
Email *
Mobile Number *
GP Name
Patient address: *
Are you experiencing symptoms of diabetes? *
If you are experiencing symptoms of diabetes, please select the one of most concern:
Is there anything else you would like the pharmacist to know:
I allow Higgins Pharmacy to contact me about this appointment. *
I understand the information provided and agree to have my blood tested for its glucose level. *
* Denotes required field
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