REGISTRATION & FORMS
Thank you for choosing Monroe Hospital for your healthcare needs.
When you arrive at the hospital for your procedure, you will be greeted
and brought to the Registration Office by one of our friendly registration
staff. During the registration process, you will be asked several questions,
including but not limited to the following:
- Social Security Number
- Date of Birth
- Phone Number
- Emergency Contact Name
- Emergency Contact Phone Number
- Name of Primary Care Physician
- Employer Information
Please also be sure to bring the following items with you to your appointment:
- Handwritten order from physician’s office (if available)
- A list of all current medications
To save time and pre-register for your procedure, you can
download a copy of the registration form and fax it to the phone number listed below.
If you wish to pre-register, you must do so at least 48 hours prior to
your scheduled appointment.
*Please note: Even if you pre-register, you will be asked to verify much of the information
upon your arrival at the hospital for your procedure. You will also need
to present your insurance cards and a photo ID at this time.
** You do not need to pre-register for any walk-in procedures such as lab
work or X-Rays.
For any questions, or to fax your pre-registration information please call
Phone: (812) 825-1111
Fax: (812) 825-0760