1. Start the referral process:

Use your own referral form or notes* or download one of our forms:

• Adult referral form
• Pediatric referral form

2. Gather records:

For adult referrals, Cardiology:

•  Acute, new onset, or with exercise:
  • Echo report
  • Stress Echo
     
• Chronic, not acute or not with exertion:
  • Echo reports
  • Echo images
  • Previous cardiac work-up
     
• With exertion:
  • Echo report Stress Echo
     
• Ongoing, history of:
  • Echo reports
  • Echo images
  • Previous cardiac work-up

For Pediatric Cardiology:

• Shortness of Breath without chest pain (with exertion):
  • Most recent chart notes including chest x-ray reports
  • ECG strips (not just report)
  • Any Echo reports
  • If applicable, Event or Holter Monitors

For adult referrals, Pulmonary Medicine: 

• Recent chart notes supporting the diagnosis
• Bronchoscopy study (if available)
• Chest imaging - Chest X-ray (CXR) & Chest CT (if available)
• Echocardiogram (if available)
• Labs supporting the diagnosis
• Arterial blood gas (ABG) (last year) (if available)
• Lung biopsy report (if available)
• All pulmonary function test reports (if available)
• Pulmonary rehab reports (if available)
• Sleep study, sleep clinic notes, nocturnal oximetry (if available)
• Sputum study (sputum and bronchoalveolar lavage results including respiratory cultures and serologies) - lab studies (if available)
• Thoracic surgery report (if available)
• Allergist records & testing as noted above if the patient saw one for asthma or other pulmonary diseases.
• Lung ventilation and perfusion scan (V/Q scan) - radiologic study (if available)
• Right heart catheterization procedure report (if available)
• Lung pathology reports (if available)