Symplicity patient questionnaire

Have you been diagnosed by a doctor with high blood pressure?*
High blood pressure is also called HBP or hypertension.

Do you have a history of cardiovascular events such as heart failure, stroke, arrhythmia, and/or coronary heart disease?*

What is a typical blood pressure measurement for you?*

Are you currently seeing a specialist about your blood pressure?*

How often do you check your blood pressure?*

What best describes your experience with high blood pressure medications?*

How many blood pressure medications are you currently taking?*

How do you feel about blood pressure medications in general?*

How concerned are you about the side effects of blood pressure medication?*

How concerned are you about the long-term risks of high blood pressure?*

What concerns you the most about having high blood pressure?*

What type of insurance do you have?*

You're almost done! Share your contact details to receive more information about the Medtronic Symplicity™ blood pressure procedure.

Preferred contact method*

Your information will be used and protected in accordance with our privacy statement.

By completing and submitting this form you are granting Medtronic permission to store your contact information and to share that information with Medtronic representatives and healthcare providers as appropriate. You agree to having these healthcare providers contact you. We may conduct analyses on information collected in order to make improvements to and provide training on our operations, products, services and customer communications. Medtronic may de-identify data collected, combining it with data collected from other sources.