Online Hospital Pre-Registration and Mammogram Scheduling
Committed to providing the most convenient methods to fulfill your health care needs, West Houston Medical Center offers Online Pre-Registration and Mammogram Scheduling.
Simply complete the 10-20 minute Online Pre-Registration and Mammogram Scheduling forms at least three (3) business days prior to your scheduled appointment. For privacy reasons, if you leave your computer idle for more than 20 minutes, your form will not be saved and you will have to begin again.
Before you begin, be sure you have all of the information listed below.
- Social Security Number (Why do we need this information?)Disclosure of your social security number (SSN) is requested from you. No statute or other authority requires that you disclose your SSN for this purpose and we may not deny services if you choose not to disclosure it. Failure to provide your SSN, however, may result in the creation of a duplicate medical record. Further disclosure of your SSN is governed by the Texas Public Information Act and other applicable law.
- Name of ordering physician
- Date of your scheduled procedure
- All insurance cards information
- Employer information
Check-in with our registration staff on the date of your scheduled service to complete the registration process. Please be advised that you will sign all consent forms during your visit.
|Online Surgical Pre-Registration||Pre-Registration Link|
Your surgeon requested that you pre-register and upload your medical history through our One Medical Passport link. Please make sure that you have the following information available before beginning:
On behalf of your health care team we thank you for participating.
Prefer to register in person?
We want your registration process to go as smoothly as possible. That is why we have created a guide to help ease the process.
You will be required to sign the following:
- Consent for treatment
- Authorization to bill insurance
Please remember to bring with you at the time of registration the following items:
- Social Security Card
- All active insurance cards
- Picture ID
- If you have an Advance Directive such as a Living Will or Durable Power of Attorney for Healthcare, please bring it with you.
Our Gallup Patient Survey
We’re always looking for ways to make our systems and procedures more patient friendly and efficient. That’s why we contract with the renowned Gallup Research Corp. to survey our patients about their experience with us. While we don’t survey all of our patients, you may receive a phone call from a Gallup surveyor, who is representing Los Robles Hospital. Please know that your information is held in strictest confidence. If you receive a phone call, we’d like to thank you in advance for your participation in the survey.