Please note that to effectively process your pre-registration we must receive your completed form at least 72 hours prior to your scheduled procedure. If you have less than 48 hours before the time of your procedure you can pre-register by telephone by calling our Admitting and Registration Office at 209.564.5101.
Monday - Friday
5:30 a.m. - 5:30 p.m.
8:00 a.m. - 12:00 p.m.
What You Will Need to Pre-Register Online
Before you begin the online pre-registration process, you will need:
- Your insurance identification card
- Procedure date and time
- Type of procedure (such as a mammogram or X-ray)
- Personal contact information
By completing this form online, you are submitting your personal information to assist in your pre-registration prior to your arrival at our facility. After you have submitted your online pre-registration form, you will be contacted by phone within 72 hours.
Please note that there will be forms that will require your signature when you arrive on the day of your procedure.
Our goal is to make your arrival at our facility as smooth as possible.
Use our form to Pre-Register Online.