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For Patients & Families
Patient Registration Information
How can I pre register?
Pre registration can be completed several different ways for your convenience. Choose one of the following options:
Online pre registration
Complete the form and transmit. If questions have not been answered, a patient access representative will obtain information when you arrive for service. To register online, please click here.
Fax the pre registration form
- Complete the online pre registration form.
- Print completed form.
- Fax to patient access department for all four facilities at (574) 247-5401.
Pre register by telephone
Call the patient access department for all four facilities at (574) 247-5400.
Be prepared to provide the following:
- Date of surgical procedure or test.
- Demographic information.
- Insurance information (on card).
- Complete physician name(s).
Hours for pre registration
The pre registration office hours are 8 a.m. to 8 p.m., Monday through Thursday, and 8 a.m. to 5 p.m. on Friday.
Is the online pre registration secure?
Patient access services supports SJRMC’s core values of respect and excellence by assuring the right to privacy and confidentiality of all patients. Click here to view our privacy policy.
