Referrals: Heart Function Clinic, Echocardiogram, Nuclear Cardiology

his section provides information outlining the levels of heart failure service across BC in relation to the patient’s needs and NYHA heart failure classification; it also provides information and forms for BC’s health care professionals to access the appropriate level of service.

Provincial Heart Function Level of Service Model

(in development)

Provincial Echocardiography Working Group Documents

 Provinical Echocardiogram Referral Form
Provincial Echocardiogram Referral Form

Provinical Nuclear Cardiology Working Group Documents

Key elements for Reporting (MUGA/MPI [Pharm/Exercise]
MUGA MPI- Pharm MPI- Exercise
Templates for Reporting  (MUGA/ MPI [Pharm/Exercise]
Template for reporting MUGA Template- MPI -Pharm Template- MPI-Exercise

Referral Form

Nuclear Cardiology Referral Form

Provincial Heart Function Clinic Referral Form

This form will assist the health care professional in understanding the information needed to expedite the patients referral to a Heart Function Clinic. The referral form will also  ensure the appropriate information is forwarded to the respective Heart Function Clinic to ensure appropriate triaging. Please fill out the form attache the appropriate information and fax to your respective Heart Function Clinic  Heart Function Clinic Referral Form  Indication for Referral to Cardiologist or Heart Function ClinicReferral Guidelines for Internal Cardiac Defibrillator (ICD) and Cardiac Resynchronization Therapy (CRT)