Patient Pre-Registration Step 1 of 5

If your procedure has already been scheduled, or you are having a baby, you can speed up your registration process by pre-registering online. To begin the registration process, please click on the link below. This form needs to be completed at least two business days or 48 hours prior to admission or scheduled procedure.

Please remember that upon your arrival at Midland Memorial Hospital you will be asked:

  • To verify your registration information
  • To present a copy of your insurance card
  • To pay any co-payments/deductibles prior to service
  • To sign authorization forms
Denotes Required Field

Appointment Information



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