Transthoracic Echocardiogram
Patient Information and Consent Form
What is an Echocardiogram?
A safe, painless heart ultrasound using sound waves to take moving pictures of your heart. It checks your heart's valves, chambers and pumping function. No radiation. No needles. No sedation.
Why has my doctor referred me?
- • To check how well your heart is pumping and assess your valves
- • To investigate chest pain, shortness of breath, dizziness or palpitations
- • To monitor a known heart condition over time
What happens on the day — Step by Step
Arrive & check in
You will be welcomed by our staff and taken to a private, curtained examination room.
Remove top clothing
You will be asked to undress from the waist up. Women will be given a gown worn open at the front. Your privacy will be fully maintained.
Lie on the examination table
You will lie comfortably on your left side on a padded table. Small sticky electrode dots are placed on your chest to monitor heart rhythm.
Cool gel applied to chest
A clear, water-based gel is spread on areas of your chest. It may feel cold but is completely harmless and wipes off easily at the end.
Sonographer scans your heart
A trained Sonographer gently moves a small probe (transducer) over your chest. You may feel mild pressure — please speak up if you are uncomfortable at any time.
Hold breath briefly (if asked)
You may be asked to take a breath and hold it for a few seconds to get clearer images. You may also be asked to change position slightly.
Test complete — 30 to 45 minutes
The scan is finished. Wipe off the gel, get dressed, and you are free to go. No recovery time needed — resume all normal activities immediately.
After the test — no risks, no downtime
- • Go home straight away — no recovery time needed
- • A specialist will review your scan and send a report to your doctor within 7 working days
- • Your health information is kept private under Australian privacy law
Privacy Notice
Collection purpose: Your personal and health information is collected by HeartWise Cardiology solely for the purpose of performing and reporting this echocardiogram and providing you with specialist cardiology care.
Storage & security: Your information is stored securely in our clinical records system, accessible only to authorised staff and treating clinicians, and retained in accordance with Western Australian health records legislation.
Disclosure: Results and relevant clinical information will be reported to your referring doctor and any other clinician directly involved in your care. Information will not be disclosed for other purposes without your consent, except as required by law.
Sensitive health information: This information is sensitive personal information under the Privacy Act 1988 (Cth) and the Australian Privacy Principles (APPs).
⚠️ Urgent care limitation: This form is for administrative consent purposes only. If you are experiencing chest pain, breathlessness, or any medical emergency, call 000 immediately.
For our full Privacy Policy or to access/correct your information, contact us at info@heartwisecardiology.com.au or (08) 6102 1655.
📋 By signing below, I confirm that I understand and agree to the following:
I understand the nature and diagnostic purpose of the echocardiogram.
I have had the opportunity to ask questions and am satisfied with the answers provided.
I consent to my personal and health information being collected, stored, and used by HeartWise Cardiology as described in the Privacy Notice above.
I consent to my results being shared with healthcare professionals involved in my care, in accordance with Australian privacy and confidentiality laws.
Sign here with your finger or mouse
By signing above, I confirm the information provided is accurate and I consent to its use for my healthcare.
Perth CBD • Nedlands • Riverton • Joondalup
T: 08 6102 1655 | F: 08 6118 5522 | E: admin@heartwisecardiology.com.au | W: heartwisecardiology.com.au