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SERVICES
GENERAL CARDIOLOGY CONSULTATION
HEART FAILURE CLINIC
CARDIO ONCOLOGY CLINIC
PRE-OPERATIVE (PRE-OP) CARDIAC ASSESSMENT CLINIC
CARDIAC RISK EVALUATION CLINIC
FITNESS EVALUATION PROGRAM
BOOK AN APPOINTMENT
CONTACT US
ABOUT US
SERVICES
GENERAL CARDIOLOGY CONSULTATION
HEART FAILURE CLINIC
CARDIO ONCOLOGY CLINIC
PRE-OPERATIVE (PRE-OP) CARDIAC ASSESSMENT CLINIC
CARDIAC RISK EVALUATION CLINIC
FITNESS EVALUATION PROGRAM
BOOK AN APPOINTMENT
CONTACT US
VITA HEALTH CARDIAC CENTER | Book and appointment
16498
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Patient Information
Last Name
First Name
Address
City
Postal Code
Phone (home)
Phone (work)
OHIP #
VC
DOB
Sex
M
F
Physician Information
Referring Physician
Billing #
Phone
Fax
Patient Information
Signature
Date
Indications
General Cardiology Consultation
Heart Failure Clinic
Cardio Oncology Clinic
Pre-Op Cardiac Assessment Clinic
Cardiac Risk Evaluation Clinic
Fitness Evaluation Program
Clinical Information
Shortness of Breath
History of MI / Stroke
Angina / Ischemic Heart Disease
Palpitations
Heart Murmur
Dizziness / Lightheadedness
Syncope
Hypertension
High Cholesterol
Diabetes
Family history of heart disease
Atrial Fibrillation /Arrythmias
Abnormal ECG
Other:
Cardiac Investigations
Echocardiogragram
Stress Echocardiogram
Exercise Test (Treadmill or Bike)
Cardiopulmonary Test
12 Lead ECG
Holter Monitoring 24hs
Holter Monitoring 48hs
Holter Monitoring 72hs
Holter Monitoring 7 days
24 hour Ambulatory BP Monitoring and Consultation (No Charge to Patients)
Instructions to Patients
Bring your health card and all your medications with you.
Please bring or ask your referring physician to forward any relevant cardiac records or investigation reports.
Wear comfortable clothing and shoes for exercise. Light meal only 2 hours before the exercise test.
Continue all your medications unless otherwise instructed by your doctor.
Please provide us with 48 hours notice for cancellation.
Spanish, Italian, Portuguese, Hebrew, Polish, korean and Russian interpreters available.
Preferable days
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Preferable time
Morning
Afternoon
We work closely with you and carry out research to understand your needs and wishes.
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