Pre-Register for Your Visit

Save time by registering online

Take advantage of the opportunity to pre-register online for your non-emergency appointment. Pre-register at least 48 hours in advance from the convenience of your home, office or any other location where you have access to a computer. To begin, fill out the form below. Be sure to include a valid email address so we can send you confirmation that we've received your paperwork. We'll also use this email to let you know if there's any more information we need.

Pre-registration Disclaimer

This is for the pre-registration of non-emergency patients only. Please submit this online pre-registration at least 48 hours in advance of your hospital check-in to ensure its timely process.

If you choose to utilize our pre-registration form, understand that you do so at your own choice and risk. Any information you submit via the pre-registration form is confidential and is only shared with third parties as outlined in our Privacy Pledge.

When you elect to electronically submit a completed pre-registration form or any other information to Lakewood Regional Medical Center through this website, you're agreeing that you do so at your own choice and risk, and that you assume all responsibility for any liability arising from such electronic submission and from any errors or omissions in the data you provide. You agree to release and hold Lakewood Regional Medical Center and its affiliates (including its directors, officers, employees, shareholders, agents and representatives) harmless from any and all liability or cause of action arising from the interception, access or use by a third party of any information submitted electronically by you through this website and from any errors or omissions in the data you provide. Additionally, the provision of any information to Lakewood Regional Medical Center by you through this website, including a completed pre-registration form, does not create or constitute any relationship between you and Lakewood Regional Medical Center, its affiliates or any of the physicians on its staff, to which any privilege may attach

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