A PHP Error was encountered

Severity: 8192

Message: Return type of CI_Session_files_driver::open($save_path, $name) should either be compatible with SessionHandlerInterface::open(string $path, string $name): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice

Filename: drivers/Session_files_driver.php

Line Number: 132

Backtrace:

File: /home/pacificcardiolog/public_html/registration/application/controllers/Form.php
Line: 6
Function: __construct

File: /home/pacificcardiolog/public_html/registration/index.php
Line: 315
Function: require_once

A PHP Error was encountered

Severity: 8192

Message: Return type of CI_Session_files_driver::close() should either be compatible with SessionHandlerInterface::close(): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice

Filename: drivers/Session_files_driver.php

Line Number: 292

Backtrace:

File: /home/pacificcardiolog/public_html/registration/application/controllers/Form.php
Line: 6
Function: __construct

File: /home/pacificcardiolog/public_html/registration/index.php
Line: 315
Function: require_once

A PHP Error was encountered

Severity: 8192

Message: Return type of CI_Session_files_driver::read($session_id) should either be compatible with SessionHandlerInterface::read(string $id): string|false, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice

Filename: drivers/Session_files_driver.php

Line Number: 166

Backtrace:

File: /home/pacificcardiolog/public_html/registration/application/controllers/Form.php
Line: 6
Function: __construct

File: /home/pacificcardiolog/public_html/registration/index.php
Line: 315
Function: require_once

A PHP Error was encountered

Severity: 8192

Message: Return type of CI_Session_files_driver::write($session_id, $session_data) should either be compatible with SessionHandlerInterface::write(string $id, string $data): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice

Filename: drivers/Session_files_driver.php

Line Number: 235

Backtrace:

File: /home/pacificcardiolog/public_html/registration/application/controllers/Form.php
Line: 6
Function: __construct

File: /home/pacificcardiolog/public_html/registration/index.php
Line: 315
Function: require_once

A PHP Error was encountered

Severity: 8192

Message: Return type of CI_Session_files_driver::destroy($session_id) should either be compatible with SessionHandlerInterface::destroy(string $id): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice

Filename: drivers/Session_files_driver.php

Line Number: 315

Backtrace:

File: /home/pacificcardiolog/public_html/registration/application/controllers/Form.php
Line: 6
Function: __construct

File: /home/pacificcardiolog/public_html/registration/index.php
Line: 315
Function: require_once

A PHP Error was encountered

Severity: 8192

Message: Return type of CI_Session_files_driver::gc($maxlifetime) should either be compatible with SessionHandlerInterface::gc(int $max_lifetime): int|false, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice

Filename: drivers/Session_files_driver.php

Line Number: 356

Backtrace:

File: /home/pacificcardiolog/public_html/registration/application/controllers/Form.php
Line: 6
Function: __construct

File: /home/pacificcardiolog/public_html/registration/index.php
Line: 315
Function: require_once

A PHP Error was encountered

Severity: Warning

Message: ini_set(): Session ini settings cannot be changed after headers have already been sent

Filename: Session/Session.php

Line Number: 282

Backtrace:

File: /home/pacificcardiolog/public_html/registration/application/controllers/Form.php
Line: 6
Function: __construct

File: /home/pacificcardiolog/public_html/registration/index.php
Line: 315
Function: require_once

A PHP Error was encountered

Severity: Warning

Message: session_set_cookie_params(): Session cookie parameters cannot be changed after headers have already been sent

Filename: Session/Session.php

Line Number: 294

Backtrace:

File: /home/pacificcardiolog/public_html/registration/application/controllers/Form.php
Line: 6
Function: __construct

File: /home/pacificcardiolog/public_html/registration/index.php
Line: 315
Function: require_once

A PHP Error was encountered

Severity: Warning

Message: ini_set(): Session ini settings cannot be changed after headers have already been sent

Filename: Session/Session.php

Line Number: 304

Backtrace:

File: /home/pacificcardiolog/public_html/registration/application/controllers/Form.php
Line: 6
Function: __construct

File: /home/pacificcardiolog/public_html/registration/index.php
Line: 315
Function: require_once

A PHP Error was encountered

Severity: Warning

Message: ini_set(): Session ini settings cannot be changed after headers have already been sent

Filename: Session/Session.php

Line Number: 314

Backtrace:

File: /home/pacificcardiolog/public_html/registration/application/controllers/Form.php
Line: 6
Function: __construct

File: /home/pacificcardiolog/public_html/registration/index.php
Line: 315
Function: require_once

A PHP Error was encountered

Severity: Warning

Message: ini_set(): Session ini settings cannot be changed after headers have already been sent

Filename: Session/Session.php

Line Number: 315

Backtrace:

File: /home/pacificcardiolog/public_html/registration/application/controllers/Form.php
Line: 6
Function: __construct

File: /home/pacificcardiolog/public_html/registration/index.php
Line: 315
Function: require_once

A PHP Error was encountered

Severity: Warning

Message: ini_set(): Session ini settings cannot be changed after headers have already been sent

Filename: Session/Session.php

Line Number: 316

Backtrace:

File: /home/pacificcardiolog/public_html/registration/application/controllers/Form.php
Line: 6
Function: __construct

File: /home/pacificcardiolog/public_html/registration/index.php
Line: 315
Function: require_once

A PHP Error was encountered

Severity: Warning

Message: ini_set(): Session ini settings cannot be changed after headers have already been sent

Filename: Session/Session.php

Line Number: 317

Backtrace:

File: /home/pacificcardiolog/public_html/registration/application/controllers/Form.php
Line: 6
Function: __construct

File: /home/pacificcardiolog/public_html/registration/index.php
Line: 315
Function: require_once

A PHP Error was encountered

Severity: Warning

Message: ini_set(): Session ini settings cannot be changed after headers have already been sent

Filename: Session/Session.php

Line Number: 375

Backtrace:

File: /home/pacificcardiolog/public_html/registration/application/controllers/Form.php
Line: 6
Function: __construct

File: /home/pacificcardiolog/public_html/registration/index.php
Line: 315
Function: require_once

A PHP Error was encountered

Severity: Warning

Message: session_set_save_handler(): Session save handler cannot be changed after headers have already been sent

Filename: Session/Session.php

Line Number: 110

Backtrace:

File: /home/pacificcardiolog/public_html/registration/application/controllers/Form.php
Line: 6
Function: __construct

File: /home/pacificcardiolog/public_html/registration/index.php
Line: 315
Function: require_once

A PHP Error was encountered

Severity: Warning

Message: session_start(): Session cannot be started after headers have already been sent

Filename: Session/Session.php

Line Number: 143

Backtrace:

File: /home/pacificcardiolog/public_html/registration/application/controllers/Form.php
Line: 6
Function: __construct

File: /home/pacificcardiolog/public_html/registration/index.php
Line: 315
Function: require_once

Pacific Cardiology

Echocardiogram Consent Form

PROCEDURE

Your doctor has referred you for a resting echocardiogram. An echocardiogram is an ultrasound of your heart which uses sound waves to produce images of your heart. This common test allows your doctor to see your heart beating and pumping blood. Your doctor can use the images from an echocardiogram to identify heart disease.

An exposed chest area is needed for this examination. The cardiac technician will have to place a transducer against your chest wall, between your ribs to gain merges. You will be asked to change positions and to alter your breathing at times through the examination. It is important that you follow these instructions, and to otherwise lie quietly and relaxed, and this will help the technician to obtain the most accurate images. The technician will take various a images and .measurements to report to your Cardiologist. The examination normally takes around 30 minutes.

RISKS OF THIS PROCEDURE

No risks are involved in a standard transthoracic echocardiogram. You may feel some discomfort from the transducer being held very firmly against your chest. The firmness is necessary to produce the best images of your heart.

CONSENT

The out of pocket fee is a echocardiogram is $50.00

Before proceeding with the test, your doctor needs your signed consent. Please feel free to ask any questions you have about the test and about the risks.

have read and fully understood the above information regarding the test procedure and associated risks. I hereby consent to undergoing the procedure of an exercise stress test to be performed at the Pacific Cardiology Centre.