Patients & Visitors

Online Pre-Registration

At Whittier Hospital Medical Center we know your time is valuable. That is why we offer online pre-registration. This online form helps you save time and lets you be better prepared for your visit. We must receive the form at least 48 hours before your scheduled procedure to effectively process your online hospital registration.

Please have all of the following information before you begin:

  • All contact information (patient, responsible party, and emergency contacts)
  • All current insurance cards (including Medicare or Medicaid)
  • Date of scheduled visit, date of procedure, or expected delivery date of your baby
  • Family information
  • Physician’s first and last names

Please check in with the registration staff on the date of your scheduled service to complete the registration process.

THIS FORM IS NOT TO BE USED TO PRE-REGISTER FOR THE EMERGENCY SERVICES. IF YOU HAVE AN EMERGENCY, CALL 911!

To Pre-Register, Click Here