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Heart Transplant Referrals

Referrals

If you are interested in having an evaluation to determine if you are a potential transplant recipient, you, your physician, or any other caregiver may contact the program.

Referring providers who have questions about referring a patient who may be a potential UW Health heart transplant candidate can call (608) 263-1690 and ask to speak to one of the heart failure/transplant cardiologists. If you wish to speak to a heart transplant surgeon, you may call (608) 262-8915.
 
Referring providers will be asked to provide the following information about the patient when calling to make a referral: name, address, phone number, date of birth, social security number, medical history, primary doctor, and insurance.
 
After the initial referral call, providers will be asked to forward the following patient records, if available: 
  • Current history and physical
  • Current labs
  • Cardiac tests including ECG, Echo (tape), stress test, cath report and film, and cardiac surgical report (if applicable)
  • Medication list
  • Most recent discharge summary
  • Mammogram, pap and pelvic exam results for females
  • Documentation of cancer diagnosis
  • Colonoscopy report (If done within past three years)
  • Advance directives or living will
  • Chest X-ray report