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, please download and send 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

  • Hamilton - Stoney Creek
    70 King St E, Lower Level
    Stoney Creek, ON L8G 1K2
  • Hamilton - Dundas
    11 Cross St
    Hamilton, ON L9H 2R3
  • Cambridge
    715 Coronation Blvd, Suite 8
    Cambridge, ON N1R 7R1
  • Welland
    3 Cross St, Unit 301
    Welland, ON L3B 5X6

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.