Admitting and Online Pre-Registration

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Admitting and Online Pre-Registration


Welcome to the St Bernardine Medical Center Pre-Registration web page.

We want your registration experience to be positive. We encourage you to complete the following pre-registration form, so that you can save time and be better prepared for your visit to our facility.

Please note that to effectively process your pre-registration we must receive your completed form at least 48 hours prior to your scheduled procedure. If you have less than 48 hours before the time of your procedure you can pre-register by telephone by calling our Admitting and Registration Office at 909-883-8711 Ext 3136. Hours of operation are Monday through Friday, 8:00am to 4:30pm.

What You Will Need to Pre-Register Online
Before you begin the online pre-registration process, you will need:

  • Your insurance identification card ( Identification Number, group number, and insurance phone number)
  • Date of Birth
  • Procedure date and time
  • Type of procedure ( Radiology, Cardiology, Outpatient Surgery or Procedure)
  • Diagnosis or Patient Complaint
  • Physician name
  • Personal contact information (address and phone)

Additional Information:
By completing this form online, you are submitting your personal information to assist in your pre-registration prior to your arrival at our facility.  After you have submitted your online pre-registration form, you will be contacted by phone within 2 business days if any further information is needed.

Please note that there will be forms that will require your signature and two forms of identification will be requested when you arrive on the day of your procedure. Any scheduled procedures will require a physician’s order prior to performing test.

Our goal is to make your arrival at our facility as smooth as possible.

Click Here to Pre-Register Online.

 

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