Get Outpatient Cardiology And Diagnostic Testing Referral Form

Completing the Outpatient Cardiology And Diagnostic Testing Referral Form online is a straightforward process that ensures necessary information is gathered efficiently. This guide provides step-by-step instructions to help users navigate through the form with ease.

Follow the steps to accurately complete the referral form online.

1. Press the ‘Get Form’ button to access the form and open it in your preferred online editor.
2. Provide the patient information by entering the patient's full name, address, and phone number. Ensure the phone number is accurate for potential follow-ups.
3. Enter the patient's date of birth and health card number in the designated fields to confirm their identity.
4. In the 'Reason for Referral' section, select the appropriate option, such as 'Cardiology Consultation' or 'Cardiac Diagnostic Testing', based on the patient's needs.
5. Indicate the urgency of the consultation by selecting either 'Urgent (<2 weeks)' or 'Elective (2-6 weeks)'. This helps prioritize the referral.
6. If the patient is on or off cardiac medications, indicate the relevant option to provide context to the cardiology team.
7. In the 'Cardiac Diagnostic Testing' section, specify which tests are required by checking the corresponding box for each test needed.
8. For 'Reason / clinical information', provide any additional relevant details that can help the cardiologist. Attach additional documentation if necessary.
9. Fill in the referring physician's information, including their name, signature, billing number, office address, and phone number.
10. Ensure all fields are completed thoroughly and review the entered information for accuracy before submitting.
11. After filling out the form, you can choose to save changes, download, or print the form as needed, and direct it to the appropriate office.

Complete the Outpatient Cardiology And Diagnostic Testing Referral Form online today to ensure timely care for those in need.