Heartscope

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Refer a Patient

Refer a Patient to Heartscope.

Using the electronic form, you can seamlessly refer a patient to Heartscope. Simply fill in the necessary information and press the submit button.

Note: If you also want to refer sleep and respiratory services as well, you can do it through this form. 

Heartscope Cardiology Referral

Patient's Details
Patient's Sex
Conditions/Symptoms (Please Tick Appropriate Boxes Below)

Cardiac Services
Select Referral Type
Patient Category
Type of Consultation
Type of Consultation
Preferred Cardiologist (General Consulting)
Preferred Cardiologist (Interventional)
Preferred Cardiologist (Arrythmia Clinic | EP)
Preferred Cardiologist (CTCA Consult)
(Subject to a 2 year referral restriction, cannot be claimed if echo was claimed within 24 months)
Select Type (Echocardiogram)
For echocardiogram please select indications:
(Subject to a 2 year referral restriction, can only be bulk billed once every 2 years)
Select Type (Stress Echocardiogram)
For stress echocardiogram please select indications:
(Can only be Bulk Billed once per every 4 weeks)
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