We are pleased to provide pre-registration documents to help make your hospital admission as smooth as possible. General pre-registration is available to all scheduled patients ahead of the date of service.
Please click the links below for forms with pre-hospital and surgery information.
If you have any questions regarding Pre-registration, contact the Call Center (626) 397-5600 Mon-Fri 7:00 a.m. – 5:00 p.m.
If you would like to pre-register for hospital services, download our Pre-Registration Form.
Please print the form, complete the information and return it to:
Attention: Call Center
100 W. California Boulevard
Pasadena, CA 91109-7013
You may also fax it to: (626) 397-2160.
Please note that when you arrive at the facility, you will still be required to provide your identification, finalize financial arrangements and sign a few forms before going to the department.
More Pre-Hospital Forms
You can also save time by filling out other Pre-Hospital information forms.
- Medication Form: A handy form that anyone can use to list medications you are taking.
Preparation for Surgery
- Pre-Hospital To-Do List: A basic checklist of requirements for surgery.
- Information Sheet: Information sheet for Informed Consent for Anesthesia Services- explains different types of anesthesia (for Spanish version click here).
- Patient Instructions for Surgery: Detailed preoperative and day of surgery instructions.
- Authorization and Consent for Surgery: A sample of the surgery/procedure consent required for all patients having surgery (for Spanish version click here).
- Consent for Transfusion of Blood or Blood Components: A sample of the authorization used for all patients who may require a transfusion during their hospital stay (for Spanish version click here).
- Hysterectomy Consent: A sample of the informed consent for the hysterectomy procedure.
- Pre-Anesthesia Evaluation: Please print, fill-out and bring with you to the hospital on the day of your surgery.
It is important to think about how you will get the care you need after you leave the hospital. We can help. Your healthcare team will help you plan for your care needs after discharge. Our Discharge Planning Form is another useful tool to help you in this process.
- Discharge Planning Form: Please print the form, fill it out and bring with you when you are admitted. This will help facilitate your discharge from the hospital.
- Planning to Leave the Hospital: Here is some helpful information tp help you plan your return home, as well as guidance for medication plans, follow-up care and more.