HEARTPLACE BAYLOR ALL SAINTS - FT. WORTH

HeartPlace BASH is conveniently located in the Baylor Scott & White Medical Center - Fort Worth campus. We have a wonderful group of physicians ready to serve you. At HeartPlace BASH, we offer a full range of cardiovascular diagnostic testing. This includes exercise stress testing, nuclear stress testing, diagnostic cardiac ultrasound, as well as stress testing with echocardiographic imaging, vascular imaging, and arrhythmia monitoring. Call us today for your appointment. We look forward to meeting you and starting your journey to a healthy heart.

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1650 West Magnolia Avenue
Suite 102
Fort Worth, Texas 76104

Electrophysiology:

Phone: 817-922-0439

Fax: 844-290-4364

Dr. Craig Delaughter

Esther Pimplekar, MSN, ACNP-BC

Hours: 8:30am-5pm (Monday - Friday)

HeartPlace Baylor All Saints Providers

HeartPlace Baylor All Saints Clinic Forms

For your convenience, we have placed various patient forms below, in the form of PDF files that you may download at your leisure. Once they have been completed, you can either mail or fax them to this office, or bring them with you to your appointment.

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BASH Clinic Fax: 844-290-4364

You will need the Adobe Reader to view and print these documents.

Full Patient Visit Packets

• New Patient Packet

• Established Patient Packet​

Individual Patient Visit Forms

• Patient Demographics Form

• Patient Privacy Notice (HIPAA)

• New Patient Questionnaire

• Established Patient Questionnaire

• Authorization For Release of Medical Records TO HeartPlace

• Authorization For Release of Medical Records FROM HeartPlace

• Blood Pressure Log

Patient Testing Instructions

• Stress Test

• Echocardiogram

• Stress Echocardiogram

• Nuclear Stress Test - AM Appointment

• Nuclear Stress Test - PM Appointment​

• Abdominal Aorta Ultrasound​

Patient Procedure Instructions

POST PROCEDURE​

• Pacemaker

• ICD

• Angioplasty/Stent

• Open-Heart Surgery