Patient Information HELP

This is Help for the current pre-registration page. This Help describes the buttons and fields on the page, the information that goes in the fields, and how to enter the information.

Note: Some pre-registration information is required. If you see this mark * before a question or statement on the pre-registration page, it means you must provide the requested information. If you do not provide the information, you will not be able to complete the pre-registration process online. You will have to go through the process by telephone instead.

Go back  button
Click this button to return to the previous pre-registration page.
Continue  button
Click this button when you have finished entering the information on the current page and are ready to continue with the pre-registration process.
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Your Privacy Rights