Patient Registration
We want your registration process to go as smoothly as possible. That is why we have created a guide to help ease the process.
During the registration process - you will be asked to provide information about yourself which will include certain demographic and financial information as well as general consent and insurance authorizations.
On the day of your registration – you will bring the following items as they pertain to your specific situation:
- Physician’s orders
- A valid drivers license or photo Identification card of the patient
- Active Insurance identification card(s)
- Employer information
- Social Security Card
- Advance Directive/Living Will, if you have one
- Emergency notification of someone outside of your home
Note: Minor Patients – must be accompanied by parent or legal guardian.
You may be required to sign the following:
- Consent for treatment
- Authorization to bill insurance
If you are a Medicare recipient, you will be required to sign:
- Medicare Secondary questionnaire
- Medicare Rights Statement
If you are a Champus recipient, you will be required to sign :
Worker’s Compensation - If you are injured at work, we must have confirmation of your insurance information in order to bill your worker's compensation insurance carrier. Please make sure we have accurate information so as not to delay a settlement.
Our Registration Office is located on the first floor in the main lobby adjacent to the Emergency Department. For more information, you can call (337) 898-6510.
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