Prosthetic Device Complications

Diagnosis
Prosthetic device complications: Prosthetic Device Complications: Defibrillator; Pacemaker; Subcutaneous pocket
Department
Cardiology

1. Start the referral process:

Use your own referral form or notes* or download our form:

Adult referral form

2. Gather records:

  • ECG Reports + Tracings
  • Holter/event monitor with full disclosure
  • Echo reports
  • Pacemaker/defibrillator notes
  • ECG+ additional testing pending medical review

3. Fax the referral and all records to 503-346-6854.

* Referral notes or forms should include:

  • Patient name, date of birth, sex, address and phone number
  • Referring provider’s name, address and phone number
  • Diagnosis or reason for referral
  • Department patient is being referred to
  • Most recent chart notes supporting the diagnosis or reason for referral

For help or to arrange provider-to-provider advice, call 503-494-4567.

Date Revised May 01, 2024