Pre-Registration for Patient Scheduled Procedures and Tests


You are entering a Web site that is secure. The information you view and submit cannot be read while in transit.

As an added convenience for patients, Jefferson Regional Medical Center is pleased to offer hospital pre-registration online.

Please note this site is for hospital use only and not for physician appointments.

You will need this information to complete your pre-registration:

Your insurance card
Referral form or letter, if appropriate
Information about your doctors, including names and addresses
Emergency contact information

Jefferson Regional Medical Center is following federal guidelines that help to protect patients health information by limiting the amount of information provided to the public without patient authorization. The Health Insurance Portability and Accountability Act of 1996 (HIPPA) is a federal law that is designed to ensure the portability of health insurance for individuals from one job to another and protect patient information. Protected health information is any health information that can be used to identify a patient and relates to health-care services provided to the patient or the payment of those services. It includes all medical records and other information, which identifies the patient, such as demographic, medical, and financial-in any form-electronic, paper, or spoken.