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Online hospital preregistration

Please fill out the information below to preregister for your hospital visit or hospital procedure. Your completed form will be saved as part of your electronic health record, reducing the amount of paperwork you will be asked to fill out when you arrive at the hospital. Thank you for your cooperation.

Please note: the form below is NOT to be used for physician clinic preregistration. Click here for the physician clinic  preregistration form.

Step 1 of 4: Choose a location and type of Pre-Registration If you are having technical issues with this form, please contact us

If your procedure/service is within 24 hours of today, please do not use this online form. Please call our pre-registration department toll-free at 1-888-844-0080.
Location (NOTE: If Prince William, click here):
Choose type of registration:  
Novant Health is concerned about the privacy of your personal and medical information. By using this electronic communication option, you agree that this Disclaimer explains security procedures that are commercially reasonable. You agree to follow these instructions, unless you have given us prior notice of possible unauthorized use as described above and we had a reasonable opportunity to act on such notice.

Communication by email, or other electronic means, cannot be guaranteed. Please do not use this form for urgent medical needs. Please do not use this form if your procedure is scheduled for less than 24 hours from now.

E-mail or electronic communication should not be taken as establishing any patient-provider relationship between Novant Health and the user.

For urgent matters, call 911.