Instructions:

1. Click on the form you want.

2. A copy of this form will be automatically downloaded to your computer and then opened
    and displayed on your screen.

3. Print this form and fill in the required information.

4. Fax or send this form and all other necessary documentation to London Cardiac Institute.
    Fax No. is 519-645-1584

5. eMail referrals to: .....coming soon

General Cardiology           Referral

Urgent Cardiology Clinic Referral

Pacemaker Referral

New ICD Referral & Guidelines 2008

Diagnostic Test     Requisition

Arrhythmia Service Referral

Lead Extraction Guidelines

Need Acrobat Reader?