Cardiology or Internal Medicine Referral

Use this online form to refer a patient to Heart and Health Clinic Cardiology or Internal Medicine for either of our clinic locations.

Alternatively, you can refer patients to us through the Ocean Referral System or by downloading and sending the referral form by email or fax.

Central Booking Line

T: (289) 760-9550
F: (905) 296-3858
E: clinic@heartandhealth.ca

Our Clinic Locations

Reason for Referral


Cardiology & Internal Medicine

Service(s) Requested


Type your first and last name below to act as your e-signature for the purpose of this referral.