Patient Forms and Pre-Registration

Patient Access at Children's & Women's Hospital has six points of entry. All Patient Access locations are inside the main hospital, with the exception of Therapy Services:

• Therapy Services is located in the Center for Child Development at 1610 Center St., southeast of the hospital. The telephone number is 251-415-1670.
• Emergency Services are registered in the Evaluation Center, at the east side entrance of the hospital. The telephone number is 251-415-1620.
• The Imaging Center, where all radiological services are performed is located at the same east side entrance. Upon entering, please sign in. The Registration staff are available at the front desk for your convenience. The telephone number is 251-415-8649.
• OB patients who are not scheduled or sent from your physician's office will report first to the Evaluation Center located at the east side entrance unless specifically told by your physician to report to another location.
• Outpatient Surgery and Day of Surgery patients should report to the main Patient Access department between 5 a.m. and 7:30 a.m. on the day of surgery. After 7:30 a.m., patients should report to Pre-Admit Registration, located straight through the main lobby in the Surgery department. The telephone number is 251-415-1629.
• The main Patient Access department is located just to the right of the Lobby upon entering the hospital. All inpatients and other outpatients should report to this area. The telephone number is 251-415-1617, and the fax number is 251-415-1002.
   

Pre-registration

Pre-registration is available to all scheduled patients prior to the date of service to expedite the check-in process. During the pre-registration process, all registration information is obtained over the telephone. When you arrive, you will be required to provide your insurance cards and sign the required forms before going to the department. Patients can pre-register for services by calling 251-415-1629.

Requirements for all registrations

Upon arrival for registration, you will be asked to verify all demographic and insurance information, and you will be required to provide the following information:

• Health insurance cards and information including address, telephone number, and policy number
• Photographic identification card
• A valid prescription or physician order for all tests
• Referral or authorization numbers, if required by your insurance
• A note giving "permission to treat" from a parent or legal guardian if the minor will be unaccompanied by the responsible party
• You also will be required to sign the Conditions and Consent for Treatment form at the time of registration
   

Advance directives

Upon admission to Children's & Women's Hospital, each patient is given a brochure regarding medical advance directives. If you would like this information before you arrive, please contact the Patient Access department during regular business hours.

Deposits/co-payments

Patients are responsible for all financial liabilities including co-payments, deductibles, and out-of-pocket expenses at the time of registration or at the time of discharge for emergency admissions. If the exact dollar amount has not been determined, you will be asked to pay the estimated amount and will be billed for the remainder.