Cardiology & Cardiac Testing

All referral forms on this website are also available as eForms for OSCAR, Avaros, Indivicare, and ACCURO EMRs. You can download some of the premade forms here from WorldEMR or fill the contact form below for any other eForms that are not listed for your EMR.

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Clinics

ClinicServicesLocationFormContactInformation
London Cardiac Institute1. Urgent Cardiology
2. Arrhythmia
3. Cardiac Testing
1055 Fanshawe Road West
London, ON
N6A 5P6
LCI Referral ArrhythmiaGeneric FormOnline referralPhone: 519-645-0146
Fax: 519-645-1584
https://londoncardiac.ca/
LHSC Cardiac TestingNon-Invasive TestingLHSC University Or VictoriaLHSC Cardiac ReferralFAX UH: 519-663-3806
Fax VH: 519-685-8084
Fax referral
SJHC Cardiac TestingNon-Invasive TestingSt. Joseph’s Hospital
Room B3-030 (Central Registration Desk)
268 Grosvenor Street
London, Ontario N6A 4V2
SJHC Cardiac ReferralPhone: 519 646-6019
Fax: 519 646-6292
Fax referral
Anti-coagulation Clinic (UH)Anticoagulation for cardioembolic indicationsLHSC University HospitalAnticoag Referral FormPhone: 519-663-3605
Fax: 519-663-3614
Fax referral
Coronary CATH Referral (CCN)Coronary CatheterizationLHSC University HospitalCCN Referral FormFax: 519-663-3069Fax Referral
Pediatric Cardiology ClinicPediatric CardiologyLHSC Victoria HospitalGeneric FormPhone: 519-685-8237
Fax: 519-685-8584
Fax Referral Specific Cardiologists Below
Cardiac RehabCardiac RebabSJHC B3-689 *many Locations in LHIN*Cardiac RehabPhone: 519-667-6704
Fax: 519-667-6532
Fax Referral
Woodstock Hospital Cardiac InvestigationsCardiac Testing and ConsultationWoodstock HospitalWoodstock Cardiac Investigation RequisitionFax: 519-421-4238Fax Referral
MyHealth ArvaCardiac Testing and ConsultationMyHealth Centre Arva
21589 Richmond St
Arva, ON
N0M 1C0
MyHealth Arva ReferralPhone:519-672-0070
Fax: 519-850-0144
Fax Referral
MedPoint Cardiac TestingCardiac Testing and ConsultationMedpoint Health Care Centre – Citi Plaza
355 Wellington St, Suite 233
London, ON
N6A 3N7
Medpoint ReferralFax: 519-663-3069Fax Referral
Cardio StudyCardiac Testing and ConsultationCardio Study of London
Suite 202-240 Wharncliffe Rd N
London, ON
N6H 4P2
Cardio Study ReferralPhone: 226-785-0460
Fax: 226-785-0466
Fax Referral
KMH Woodstock Cardiac TestingCardiac Testing and ConsultationKMH Cardiac Testing
437 Norwich Ave
Woodstock, ON
N4S 3W5
KMH Cardiology ReferralPhone: 1-877-564-5227
Fax: 1-877-564-3297
Fax Referral
Medi-Share StrathroyHolterStrathroy Middlesex General HospitalSMGH Holter RequisitionPhone: 519-245-5295 ext. 5531
Fax: 519-246-5919
Fax Referral

Physicians

PhysiciansSubspecialty / InterestLocationFormContactInformation
Dr. Thain, Andrew1. Hypertrophic CardiomyopathyLHSCGeneric FormPhone: 519-663-3010
Fax: 519-663-3578
Fax consult
Dr. McCarty, David1. General Cardiology
2. Hypertrophic Cardiomyopathy
LHSCGeneric FormPhone: 519-663-3227
Fax: 519-663-3578
Fax Consult
Dr. Pickering, Geoffrey1. General CardiologyLHSCGeneric FormPhone: 519-663-3973
Fax: 519-434-3278
Fax Consult
Dr. Shoemaker, Gerald1. General CardiologyLHSCGeneric FormPhone: 519-663-3485
Fax: 519-663-3484
Fax Consult
Dr. Wisenberg, Gerald1. General CardiologyLHSCGeneric FormPhone: 519-663-3083
Fax: 519-663-3084
Fax Consult
Dr. Tang, Anthony1. General CardiologyLHSCGeneric FormPhone: 519-663-3746
Fax: 519-663-3782
Fax Consult
Dr. Weingert, Michael1. General Cardiology190 Wortley Rd, London ON, N6C 4Y7
230 First Ave, St. Thomas ON, N5R 4P5
Generic FormPhone: 519-663-7800
Fax: 519-663-0933 (St.Thomas)
Fax: 519-642-1158 (London)
Fax Consult
Dr. Brown, Robert1. General CardiologyMedPoint Healthcare 1295 Riverbend Road, London Ontario N6K 0G2Medpoint ReferralPhone: 519-432-1919
Fax: 519-432-9529
Fax Consult
Dr. Calvin, James 1. General CardiologyLHSC – VHGeneric FormPhone: 519-663-3892
Fax: 519-663-8619
Fax Consult
Dr. Suskin, Neville1. General Cardiology
2. Cardiac Rehabilitation
SJHCGeneric FormPhone: 519-646-3583
Fax: 519-646-6139
Fax Consult
Dr. Bergin, Lynn1.Adult Congenital HDLHSCGeneric FormPhone: 519-663-3486
Fax: 519-663-3487
Fax Consult
Dr. Siu, Sam1. Adult Congenital HD
2.Pregnancy & HD
LHSCGeneric FormPhone: 519-434-3278
Fax: 519-434-3278
Fax Consult
Dr. Bagur, Rodrigo1. Interventional (PCI | TAVI)LHSCGeneric FormPhone: 519-663-3997
Fax: 519-434-3278
Fax Consult
Dr. Diamantouros, Pantelis1. Interventional (PCI | TAVI)LHSCGeneric FormPhone: 519-663-3329
Fax: 519-434-3278
Fax Consult
Dr. Garg, Pallav 1. InterventionalLHSCGeneric FormPhone: 519-663-3627
Fax: 519-663-2997
Fax Consult
Dr. Jablonsky, George1. InterventionalLHSCGeneric FormPhone: 519-663-3266
Fax: 519-434-3278
Fax Consult
Dr. Lavi, Shahar1. InterventionalLHSCGeneric FormPhone: 519-663-3611
Fax: 519-663-3117
Fax Consult
Dr. Sridhar, Kumar 1. InterventionalLHSCGeneric FormPhone:  519-663-3474
Fax: 519-663-2997
Fax Consult
Dr. Teefy, Patrick1. Interventional (PCI | TAVI)LHSCGeneric FormPhone: 519-663-3075
Fax: 519-663-3516
Fax Consult
Dr. Davey, Ryan1. Heart Failure
2. Cardiac Transplant
3. Pulmonary HTN
LHSCGeneric FormPhone:  519-663-3428
Fax: 519- 663-3764
Fax Consult
Dr. De, Sabe1. Heart FailureLHSCGeneric FormPhone:  519-663-3428
Fax: 519- 663-3764
Fax Consult
Dr. McKelvie, Robert1. Heart Failure
2. Cardiac Rehab
LHSCGeneric FormPhone: 519-646-6175
Fax: 519-646-6139
Fax Consult
Dr. Smith, Stuart1. Heart Failure
2. Cardiac Transplant
3. Cardio-Oncology
LHSCGeneric FormPhone:  519-663-3428
Fax: 519- 663-3764
Fax Consult
Dr. Dias, Bryan1. Cardio-OncologyLHSCGeneric FormPhone: 519-663-3483
Fax: 519-663-3499
Fax Consult
Dr. Boughner, Derek1. Internal Medicine – CardiologyLHSCGeneric FormPhone: 519-663-3262
Fax: 519-434-3278
Fax Consult
Dr. Mathew, Andrew1. General Cardiology
2. Cardiac Rehabilitation
LHSCGeneric FormPhone: 519-663-3120
Fax: 519-663-3578
Fax Consult

Pediatric Physicians

Pediatric PhysiciansSubspecialty / InterestLocationFormContactInformation
Dr. Grattan, Michael1. Pediatric CardiologyLHSC Victoria HospitalGeneric FormPhone: 519-685-8237
Fax: 519-685-8584
Fax Consult
Dr. Norozi, Kambiz 1. Pediatric Cardiology
2. Congenital Heart Defects
LHSC Victoria HospitalGeneric FormPhone: 519-685-8237
Fax: 519-685-8584
Fax Consult Speaks German and Persian
Dr. Rosenberg, Herschel1. Pediatric Cardiology
2. Fetal Echo
LHSC Victoria HospitalGeneric FormPhone: 519-685-8237
Fax: 519-685-8584
Fax Consult
Dr. Welisch, Eva1. Pediatric CardiologyLHSC Victoria HospitalGeneric FormPhone: 519-685-8237
Fax: 519-685-8584
Fax Consult Speaks French, German, Spanish

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