CHRISTUS Health Online 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)
Date of Birth
Date of Birth
Primary Care Physician (PCP)
Ordering Physician (OP)
Maternity Patients
If maternity services for delivery, what is your due date?
What was the date of your last menstrual period?
Newborn Physician Information
I agree to Terms and Conditions
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