Thank you for choosing HeartPlace! In order to make the referral process as easy and convenient as possible. Our office will contact the patient, make the appointment, and then inform your office of the date and time. Depending upon the service desired, our office may request pertinent medical records. Once the consultation and/or test are completed, you will receive a report detailing our findings and recommendations. If we can improve your experience with HeartPlace in any manner, please do not hesitate to call. And once again thank you for choosing HeartPlace.
Each office is staffed by scheduling personnel who will be happy to make appointment requests via telephone. Just call the appropriate office with the patient's name, contact information, and the desired service to be performed (consultation, test). You may find the telephone number for any HeartPlace office by going to the Find A Clinic page.
Some of the HeartPlace offices offer a fax referral option. If you see the link below to the particular office you wish to refer, you may click on that link and download the Referral form specific for that office. Simply fill in the pertinent information and fax it back to our office. You may find the fax number for any HeartPlace office by going to the Find A Clinic page.
Referral Request Forms:
Each clinic has a customized form with their fax number on it. Choose from the clinic list below for an individualized referral form. You will also need the Adobe Reader to view and print these documents. Use the icon below to download Adobe.