Pediatric Cardiology Referral Form

Streamline Pediatric Cardiology Referrals with Paperform

When a child presents with potential cardiac concerns—whether a heart murmur detected during routine examination, exercise intolerance, growth delays, or a family history of congenital heart disease—timely and accurate specialist referral is critical. This Pediatric Cardiology Referral Form template helps pediatricians, family physicians, and primary care providers communicate comprehensive clinical information to pediatric cardiologists efficiently and securely.

Why This Template Works for Healthcare Providers

Built specifically for pediatric and cardiology practices, this referral form captures all the essential information cardiac specialists need to prioritize cases and prepare for consultations: presenting symptoms, physical examination findings (including detailed heart murmur characteristics), exercise tolerance, growth parameters, relevant medical history, and family cardiac history. By standardizing the referral process, you reduce back-and-forth phone calls, ensure nothing critical is missed, and help pediatric cardiology teams triage urgent cases faster.

The structured format includes conditional fields that appear based on specific findings—for example, detailed murmur characteristics only appear when a murmur is indicated—keeping the form concise while capturing comprehensive clinical detail when needed. This makes it easy for busy pediatricians to complete referrals quickly without sacrificing thoroughness.

Automate Your Referral Workflow with Stepper

Once a referral is submitted through Paperform, you can use Stepper to automate what happens next. Automatically send the referral details to your cardiology practice management system, create appointment requests, notify the specialist team via email or Slack, and send confirmation messages to both the referring provider and the patient's family. You can even set up routing rules so urgent cases (like cyanosis or severe symptoms) trigger immediate notifications to on-call cardiologists, while routine referrals flow into the standard scheduling queue.

Enhance Security with Papersign

For practices that require signed referral authorizations or consent for specialist consultation, you can integrate Papersign to automatically generate signature-ready documents from each referral submission. Parents can electronically sign consent forms, insurance authorizations, or information release documents, creating a complete audit trail that stays connected to the original referral.

Perfect for Pediatric and Specialty Practices

This template is ideal for pediatricians, family medicine physicians, school health providers, and pediatric nurse practitioners who regularly refer to pediatric cardiology. It's equally valuable for pediatric cardiology practices looking to standardize incoming referrals, reduce incomplete referrals, and improve care coordination across providers.

With Paperform's healthcare-grade security features and integration capabilities, you can confidently digitize your referral process while maintaining the clinical detail and professional standards your practice demands. Please note: while Paperform is SOC 2 Type II compliant and trusted by healthcare organizations worldwide, it is not a HIPAA-compliant solution. Ensure your use case aligns with your practice's compliance requirements.