If you have any questions regarding this form, please contact Pre-Arrival at 616.252.4463.
- Complete pre-registration at least 24 hours prior to your visit. For your privacy, all information will be sent over a secure connection.
- Upon arrival, patients who use this form need to check in at Registration/Admissions to finalize registration.
- Please bring the following items:
- Your insurance cards and photo I.D.
- Any paperwork from your physician
- Any forms from your insurance provider
UM Health-West Hospital Staff may need to contact you in advance of your scheduled procedure to obtain or provide additional information.
Please read the following important disclosure statement before pre-registration.
To view PDF files you’ll need to download the free Adobe Acrobat Reader.
This form will take approximately 5 minutes to complete. You will need your insurance card and the patient’s Social Security number in order to complete the pre-registration process.