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Advanced Heart Failure and Heart Transplant Phone: 8437929259 Fax: 8437921729 After Hours: MEDULINE 8009225250 MUSChealth.orgReferral Form: Advanced Heart Failure and Transplant Patient Name:___ SS#___
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Advanced heart failure is a stage of heart failure where the heart muscle is unable to pump enough blood to meet the body's needs.
Patients with advanced heart failure may be required to file advanced heart failure forms as part of their medical records.
Advanced heart failure forms typically require information about the patient's medical history, symptoms, medications, and treatment plan.
The purpose of advanced heart failure forms is to help healthcare providers assess, monitor, and treat patients with advanced heart failure.
Information such as medical history, symptoms, medications, and treatment plan must be reported on advanced heart failure forms.
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