Kimberley Region Online Referal Form
KIMBERLEY CARDIOLOGY REFERRAL
PATIENT DETAILS
Investigations
BROOME KUNUNURRA DERBY HALLS CREEK FITZROY CROSSING BALGO
Cardiology Consultation
Echocardiogram
ECG Exercise Stress Testing
Dobutamine Stress Echo
Exercise Echocardiography
Holter Monitor (24 -72 hour)
Event Monitor (7 day)
30 Day Event Monitoring
Ambulatory BP Monitoring
URGENT

* For diagnostic exercise testing, patients should discontinue B blockers, digoxin, verapamil and diltiazem 48 hours prior to testing.

Book patient for follow-up cardiology consultation if indicated by the test results.
Clinical Notes
ARF/RHD
Referring Doctor
KAMS BRAMS DAHS YYMS OVAHS BDP BMC KMG KM
Report Preference
ELECTRONIC
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