CHRISTUS Health Patient Pre-Registration

Welcome to CHRISTUS Health online patient pre-registration.

Please complete this convenient online patient pre-registration to save time on the day of your procedure. The pre-registration information must be completed at least three business days before your procedure. Note: Completing the online pre-registration form now will limit registration at the time of service to include signing of patient consents only. Please bring a photo ID, insurance card, and physician's orders on the day of the procedure.

CHRISTUS Health protects your confidential information and for this reason you are now in a secure window. Your information will be kept in strict confidence. For the health and safety of all, CHRISTUS Health campuses are tobacco-free.

Thank you for choosing CHRISTUS Health.

Have you been to a CHRISTUS facility?


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DOB
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Best time to contact


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Guarantor/Responsible Party (if different from above)
Responsible Party's DOB
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Patient Insurance Information (Please bring insurance card and photo ID)
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Date of Birth
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Date of Birth
Primary Care Physician (PCP)
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Ordering Physician (OP)
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Maternity Patients
If maternity services for delivery, what is your due date?
What was the date of your last menstrual period?
Newborn Physician Information
Terms and Conditions
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