Healthe Heart referral

Cardiac Testing Service

T: 02 4918 0150

E: Lng.healtheheart@healthecare.com.au

Online referral

Cardiac testing request (Healthe Heart)

Fields marked * are required.

Patient details

Name *

Address

Date of birth *

Telephone

Medicare number

Ref

Exp

Health fund

Membership no.

Cardiac investigation

Urgency

Urgent Routine

Investigation requested

Exercise Stress Echocardiogram Echocardiogram Holter Monitor Event Monitor

Inpatient investigation (if applicable)

Ward

Bed number

At Healthe Heart Or bedside

Clinical details

Reason for testing

Medications

Current medications

Referring doctor details

Dr Arshad Khan

Level 1, 43 Dickinson Street, Charlestown NSW 2290
Phone: 02 4056 1120 · Email: admin@khancardiology.com.au
Provider No: 5704344X

CC (optional)

Testing location

Where should this testing take place? *

Maitland Private Hospital — Medical Centre 1, Level 1, Suite 5, 175 Chisholm Road, East Maitland NSW 2323 Lingard Private Hospital — Main Building Level 1, 23 Merewether Street, Merewether NSW 2291 Charlestown Specialist Centre — 43 Dickinson Street, Charlestown NSW 2290

This request is sent to Healthe Heart and Khan Cardiology. For urgent testing, please also call 02 4918 0150.

General & Interventional Cardiology in the Hunter region — Charlestown, East Maitland and Belmont.

Practice

About Dr Khan
Services
Contact

For referrers

Refer a patient
Healthe Heart testing
Send an enquiry

Contact

02 4056 1120
admin@khancardiology.com.au
Fax: 02 4989 6460