Cardiac Care Network

Referral Forms & Instructions

The Cardiac Care Network of Ontario (CCN) is an advisory body to the Ontario Ministry of Health and Long Term Care. Its goals are improving quality, efficiency, access and equity in the delivery of cardiac services in Ontario. The network has two primary functions: coordinating the provision of adult cardiac services with the aid of a computerized registry, and advising the Ministry on issues related to adult cardiac services.

Adults who are going to have a cardiac catheterization, angioplasty or surgery procedure are registered on CCN's computer system. Regional Cardiac Care Coordinators with data entry staff, in each of the cardiac centers maintain the registry. They work with doctors to monitor patients until their procedure.

CCN's patient registry has included cardiac surgery since 1990. It is widely recognized as an effective way to facilitate and monitor access to cardiac care. As a result of this success, expansion of the registry began in 2000 to include cardiac catheterization, angioplasty and stent procedures. Please visit the Cardiac Care Network's website for more information on CCN's role in reducing wait times as well as some of their publications.



Referral Forms & Instructions

Cardiac Catheterization and Angioplasty/Stents

Tel: 519-685-8500 ext. 37888
Fax: 519-663-3069

Cath Referral Form (page 1)
Definitions (page 2)


Arrhythmia Services

Tel: 519-685-8500 ext. 35303
Fax: 519-663-3782

ICD & CRT Referral Form


Cardiac Surgery

Tel: 519-685-8500  ext. 37889
Fax: 519-663-2948

Cardiac Surgery Referral Form

General Instructions:

Please fax completed forms directly to the Regional Cardiac Care Coordinator at London Health Sciences Centre at the fax number indicated for each referral form. Please note that this form is for use by referring physicians only; referrals cannot be made by patients or other non-physicians.

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Last Updated June 3, 2011 | © 2007, LHSC, London Ontario Canada