Thank you for choosing to pre-register for your upcoming visit at Kosciusko Community Hospital. We are very proud of our Pre-Registration Department, allowing patients to register in advance. We hope the convenience and coordination of these services prove beneficial to you. Please read the following information below with some general tips and instructions.

You can pre-register one of two ways:

1. You can pre-register on-line by completing and submitting the pre-registration form as indicated below. Please note there are required fields you must complete. Once you have submitted your information to us you will receive a confirmation of our receipt, and your pre-registered! Click Here to fill out our PreRegistration form; or

2. You can also call the Pre-Registration Department at (574) 372-7892 or (800) 828-5628, ext. 7892 between the hours of 7:00 a.m. and 6:00 p.m. A coordinator will ask you some general questions validating your information. Your information will then be entered into our computer system and your chart will then be prepared for the day you arrive. It's that simple! (Please keep in mind that we are taking other calls and your call may be placed on hold for a short period of time. Because of serving other patients, you will have the option to leave a message and your call will be returned promptly.)

A few things to keep in mind:

• Please arrive at least 30 minutes before your appointment.

• Please stop at the Information Desk and let us know you are pre-registered. This will help us locate your chart.

• You will then be directed to a registrar to sign your consent forms. We will also need to get copies of your insurance cards.

Questions or Concerns?

Please contact the Pre-Registration Department Manager at (574) 372-7833.

Revised: April 24, 2009