- Cardiac Clinics Referral Form
- This is a generic form that can be used for all St Paul's Cardiac Clinics including Cardiac Rehab. Open form
- Cardiac Sarcoidosis Clinic
- Cardiac Sarcoidosis Referral Form
- Cardiology Telehealth Referral Form
- Use this form if you want to book a Cardiology telehealth visit. If you download this form, it is fillable for your convenience: Referral to Cardiology Telehealth
- Atrial Fibrillation Clinic Referral Form
See Cardiac Clinics Referral Form above. For patients with known or suspected atrial fibrillation who are not yet on recommended treatments.
- Yasmin & Amir Virani Provincial Adult Congenital Heart Program
Yasmin & Amir Virani Provincial Adult Congenital Heart Program (VPACH)
- Assessment and cardiac management for adults with congenital heart disease.
- Cardiac Obstetrics Clinic Referral Form
Cardiac Obstetrics (COB) - Pre-pregnancy counseling and cardiac care to women with congenital and acquired heart disease at risk of developing heart complications during pregnancy. Please include number of weeks pregnant.
- Heritable Aortopathies (HA)
Comprehensive, multisystem assessment genetic disorders that effect the aorta.
- BC Inherited Arrhythmia Referral Form
Multidisciplinary screening, evaluation and genetic counseling for patients/families affected by, or at risk for, an inherited arrhythmia, sudden unexplained cardiac arrest, sudden unexplained death, or sudden infant death syndrome
- Transcatheter Valve Implantation Referral Form
Information for doctors who want to refer patient who have significant valvular disease and is suitable for Transcatheter Valve Implantation.
Refer if your patient has significant valvular disease and is suitable for Transcatheter Valve Implantation. This forms goes with the General Cardiology Referral Form and the Lab Requisition for General Cardiology Referral.
- Pacemaker or Implantable Defibrillator Referral Form
If your patient requires assessment for or insertion of either of these devices.
- Hypertrophic Cardiomyopathy Clinic
- Chest Pain Clinic Referral Form
- Other Referral Forms
If you have questions regarding referrals or require more information, please contact:
Phone: 604.806.9139 | Fax: 604.806.9150