For Cath Lab Procedures or Inpatient Transfer 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the patient’s personal information, including name, address, phone number, health card number, date of birth, and gender. This section is crucial for identifying the patient accurately.
3. Indicate the urgency of the request by selecting either 'Outpatient' or 'Inpatient' and specify if it is 'Urgent' or 'Semi-Urgent'.
4. Provide a brief clinical history and any special instructions relevant to the patient's condition. This helps in prioritizing care effectively.
5. Select the reason for referral from the provided options such as Coronary Artery Disease or Valvular Heart Disease. Ensure to check all applicable boxes.
6. Complete the requested procedure section by marking all relevant procedures that apply to this referral.
7. Fill out any additional assessments required, including ECG results and comorbidity assessments. This information is vital for comprehensive patient evaluation.
8. Finally, review all entered information for accuracy before submitting your form through our platform.

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