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Complex Arrhythmia Clinic - Referrals

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​​​​​Urgent Referral​​​

If your patient needs immediate, urgent care, please send them to the emergency department ​

 

Alternatively for Urgent VT referrals​​​

Download and complete the VTArrhythmia Referral Form PDF Iconreferral form and fax referral form to theUrgent VT Acute Care Program PDF IconUrgent VT Acute Care Program attention Leora Wanounou at 416 340 5338 or call VT hotline 416 419 5672.

After 5:00 pm, please page the EP physician on-call through locating 416 340 3155.

 

Standard R​​​eferral

To complete the standard referral process, first download and complete the PDF icon imageCCN Heart Rhythm Referral form as well as the Complex Ablation referral formComplex Ablation Referral Form PDF IconComplex Ablation referral form

​Once you have completed the form:

  • Fax it to our central fax at 416 340 5338 Attention: Nancy Buckman (Marco)

Please ensure that the form is complete; all relevant clinical and patient safety information is needed in order to facilitate a timely booking

Our office will call the patient to inform them of their first appointment.

Our office is responsible for providing the patient with the appointment information, including time and location, and booking any pre-consultation tests and imaging required.

 

Checklist for a Complete Referral

In addition to the completed referral forms, make sure to include:

  • A letter of referral
  • Clinical notes
  • Documentation of arrhythmia (12 lead ECG if possible)
  • Diagnostic tests, echocardiogram, holter monitor, MUGA
  • Recent blood work ​

More Referral Links

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Go to the ​Complex Arrhythmia Clinic