Cardiac Resynchronization Therapy Defibrillator
Cardiac Resynchronization Therapy Defibrillator
Your CRT-D system information
Have your doctor or nurse complete these forms before you go home from the hospital. CRT-D Model Number:______________________________ CRT-D Serial Number: ______________________________ CRT-D Features: RF telemetry LATITUDE Implant Date: _____________________________________ Lead Model/Serial Numbers: _________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________
Your medical contact information
Electrophysiologist Name/Phone Number: ________________________________________________ Cardiologist Name/Phone Number: ________________________________________________ Hospital Name/Address/Phone Number: ________________________________________________ ________________________________________________ Medications (list): __________________________________ ________________________________________________ ________________________________________________
By Mail: Boston Scientific Corporation 4100 Hamline Avenue North St. Paul, Minnesota 55112-5798
By Telephone: Patients and families: 1.866.484.3268 Medical professionals: 1.800.CARDIAC (227.3422) Worldwide: 1.651.582.4000
On the Internet:
By E-mail: customercare@
Medical Records: 1.800.PATDATA (1.800.728.3282) 7 a.m.?7 p.m. (Central Time), Monday?Friday e-mail: medical.records@
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