THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION YOU SUBMIT THROUGH THE ONLINE PRE REGISTRATION FEATURE OF THIS WEB SITE MAY BE USED AND DISCLOSED. ALSO PLEASE REVIEW THE SPARROW HEALTH SYSTEM WEB SITE SECURITY POLICY AND THE SPARROW HEALTH SYSTEM NOTICE OF PRIVACY PRACTICES FOR MORE INFORMATION.

  • All information submitted in the online pre-registration form will be treated by Sparrow Health System as a confidential part of your medical record.
  • The information you submit on this form is made available to Sparrow Health System personnel for the purpose of pre-registering you as a patient. By submitting this form, you are authorizing Sparrow Health System to contact your insurance company for verification of coverage and payment.
PLEASE NOTE:

Upon arrival at the hospital or outpatient site, you will need to complete the admission process by:
    1.  providing copies of your insurance card(s)  (Remember to bring your insurance card(s) with you each time you come for services at Sparrow); and
    2.  signing authorization forms.

This form takes approximately 10-15 minutes to complete, depending on your information.

To make completing the form easier, before continuing please gather your insurance card(s), information about your visit/procedure and emergency contact information.

Sparrow Health System requires 36 hours prior notice for all online pre-admission registration.
Continue to Secure Patient Pre-Registration
Click here to Pre-Register ONLY if your appointment is at least 36 hours from the time you are completing this form. Registrations not meeting this requirement may not be completed upon your arrival, causing delays.





Last modified on: 6/9/2009 9:30:20 AM