Heart Health Referral Forms for Health Care Professionals

Heart Health Referral Forms for Health Care Professionals

AFIB Clinic Referral Form
BC Cardiac Catheterization Referral Form 
Cardiac Catheterization Nursing Checklist
BCIAP Referral Form - Vancouver
BCIAP Referral Form- Victoria
Echocardiography Requisition
Echcardiography - Memo for Family Doctor's Ordering Stress Echo
Electrodiagnostic Services Request for Exam Form
Cardiac Rehab/ Risk Reduction Program Referral Form
Guidelines for Suspected Pacemaker Pocket Infection
Heart Failure Transition Tool (For Acute Care Units)
Heart Function Clinic Referral Form
Heart Rhythm Device Implant Referral Form
Hypertrophic Cardiomyopathy Clinic Form
ICD Deactivation Referral Form
ICD Deactivation Patient Consent Form
MIBI Scan Requisition
Overnight Oximetry Referral Form
Take Heart Physician Recommendations for Exercise
Transcatheter Aortic Valve Implantation (TAVI) Referral Form 
Vascular Risk and Prevention Referral Form

Services

Atrial Fibrillation Clinic - Heart Health
Cardiac Rehabilitation Program - Heart Health
Echocardiography - Heart Health
Electrodiagnostics - Heart Health
Electrophysiology & Heart Catheterization - Heart Health
Heart Function Clinics - Heart Health
Pacemaker Clinics - Heart Health

News & Events

Nanaimo Heart Function Clinic team

Island Health expands heart health services in the Central Island

People living with heart health challenges will have access to more exam rooms, improved privacy and enhanced educational supports thanks to the expansion and relocation of Island Health’s Nanaimo Heart Function Clinic.

Read more

parking sign

Pay parking resumes March 4, 2022

Effective March 4, 2022, pay parking will resume at all Island Health sites that previously had pay parking in place. 

Read more

Caring for the Vulnerable

Caring for the Vulnerable

Healthcare professionals provide care in many settings, including hospitals, clinics, schools and people’s homes, but for those individuals who don’t have a fixed address and require care, some community health services staff go to them. 

Read more