Cardiovascular Investigation Unit Referral Form Cardiovascular Investigation Unit Referral Form 2026

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  1. Click ‘Get Form’ to open the Cardiovascular Investigation Unit Referral Form in the editor.
  2. Begin by filling out the 'Patient Information' section. Enter the patient's surname, given name, date of birth, sex, health card number, address, city, postal code, home phone, and alternate contact number.
  3. Next, complete the 'Date of referral' and PIN# or J# fields to ensure accurate tracking of the referral.
  4. Proceed to the 'Referring Physician Information' section. Print the physician's name and enter their physician number, address, city, postal code, phone number, fax number, and email.
  5. In the 'Reason for Exam/Clinical History' field, provide a detailed explanation of why the referral is being made.
  6. Indicate if the patient has an intracardiac device by checking the appropriate box. Select any required tests from the list provided.
  7. Specify if assistance is needed for transfer by selecting one of the options available.
  8. Finally, inform your patient about their appointment details including date and time. Remind them to arrive 20 minutes early and check St. Joseph’s website for additional information.

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