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here are some additional instructions:
Measuring the circumference of your arm:

To determine your correct cuff size place the cloth tape measure around the middle of your upper arm between your elbow and your shoulder. If your arm size is 7-9 inches you need the small adult cuff, 9 to 13 inches the standard cuff, and 13-17 inches the large adult cuff. The standard adult cuff is supplied with the monitor.
Tips:
Avoid eating, smoking, and exercising for at least 30 minutes before taking a measurement.
Avoid taking measurements during stressful times. Stress raises blood pressure.
Measurements should be taken in a
quiet place. You should be in a relaxed, seated position, with your feet flat on the floor.
Remain still and do not talk during the measurements.
Rest comfortably in a relaxed environment for at least 15 minutes before you take a blood pressure measurement.
Keep a record of your blood pressure and pulse for your doctor. A single measurement does not provide an accurate indication of your true blood pressure. You need to take and record several readings over a period of time. Try to measure your blood pressure at the same time each day in a similar environment for consistency.
Wait 2-3 minutes before taking another blood pressure measurement. You may require more rest time between readings depending on your individual physiological characteristics.
Unit Set-Up:
Inserting the battery:

Slide off battery cover in the direction of the arrow.

Insert the 4 AA batteries making sure the positive and negative polarities match the polarities shown in the battery compartment.
When you need to replace the batteries in your unit, remove and replace all of the batteries at the same time. We always recommend long-life alkaline batteries for best performance.

Replace the battery cover.

Insert arm cuff plug into air jack on monitor.
For AC adapter operation:

Insert plug into the AC jack on the monitor.
Insert the electrical plug into a wall outlet.

Insert arm cuff plug into air jack on monitor.
Applying the cuff:

Slide your left arm through the cuff and position approximately 1/2 inch above the elbow.
Position the green marker over the artery on the inside of your arm.

Press the sewn hook material firmly against the pile side of the cuff.

The cuff should make direct contact with your skin. You should be able to easily fit your index finger between the cuff and your arm.

Relax your arm comfortably on table with palm upward so the cuff is at the same level as your heart.
Getting your readings:

Press the ON/OFF button

When the heart icon appears on the display, press the START button, remain still.

The cuff begins to inflate. Numbers appear on the display and the heart icon flashes. Cuff deflates and measurement is complete. To stop the measurement at any time press the ON/OFF button, the monitor will stop inflating.

Your blood pressure and pulse rate are displayed. Consult your physician for specific information about your blood pressure.