Testing appointments with beta blocker page.09-23-2013
Ordering Physician: Patient: ____________________________________
Please note that you are scheduled for cardiovascular testing and NOT a physician’s visit.
If you would like an appointment to review your testing results with a physician, an office visit can
be scheduled. A co-payment will be collected for this office visit.
You have been scheduled for the following test: [No preparation required]
Echocardiogram Vascular Ultrasound Holter Monitor 45 minute test 30-90 minute test 15 minute test
You have been scheduled for the following test:
[Please review instructions below]
Echo Stress Echo Stress Echo Nuclear Stress Test Microvolt T Wave Alternans PET Nuclear Stress Test 1 hour test 45 minute test 3 hour test 1 hour test 45 minute test
1. Please take all of your medications as usual except beta blockers [see list on back].
2. If you are taking a beta blocker, do not take it the day before and the day of testing.
You may have a light meal and a non-caffeinated drink, up to 2 hours BEFORE your test.
Do NOT consume ANY caffeine or alcohol for at least 24 hours BEFORE your stress test.
Wear comfortable clothing and athletic/rubber soled shoes.
Do not apply any after shave, creams, lotions, or powder to your chest and neck area on the day of
If you have a history of wheezing, asthma, chronic lung disease, or take Theophylline or Aminophylline type medications, please inform the technician and if applicable, bring your inhaler to
3. Diabetic patients: If you are on insulin or oral hypoglycemic medications, eat a light snack 2 hours before your appointment and TAKE your diabetic medications. ***PET PATIENTS*** DO NOT TAKE ANY BLOOD PRESSURE MEDICATIONS, HEART MEDICATIONS, OR ANY FORM OF NITRO, THE NIGHT BEFORE OR THE DAY OF YOUR TEST. Nuclear / PET Test: Your appointment will take approximately 3 hours. Materials for nuclear testing are
expensive and ordered for each individual patient.
If you must cancel or change your appointment please do so 24 hours before your scheduled appointment time. Patients who cancel their appointment with less than 24 hours notice will be charged a $75 wasted material fee. PET patients will also be charged a $75 wasted material fee for appointments that are cancelled less than 24 hours in advance. Scheduled testing: _______________________________________________ Date and Time: __________________________________________________ Location of testing: Texas Clinic at Prestonwood; 6957 West Plano Parkway at Marsh Lane; Suite 1000; Plano, TX 75093
[Please park on the south side of the building. Enter through the double glass doors. We will be on your immediate left]
Irving Office: 6500 Sierra Drive, Suite 150; Irving, TX 75039
Flower Mound Office: 4001 Long Prairie Road, Suite 123; Flower Mound, Texas 75028
Dallas (Launey) Office: 9528 Webb Chapel Road; Dallas, TX 75220
(972) 939-8294 BRAND NAMES GENERIC NAMES
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Ordering Physician:
(972) 939-8294