Pre-Registration Form

Welcome to Indiana University Health Bloomington Hospital. We thank you for choosing us for your upcoming test, procedure or maternity visit. Now, you can save time and register online before you arrive!

A PHYSICIAN ORDER IS REQUIRED FOR ALL SERVICES.

Pre-registration is available for all scheduled tests and procedures, as well as maternity services.

If you have a written order from your physician/provider for a test or procedure that does not require an appointment (such as routine lab work or X-ray for chest, arm, leg, etc.), without a scheduled test or procedure, please do not complete this form. You need to simply report to the Patient Registration area upon arrival to Bloomington Hospital.

Also available, if you prefer, is pre-registration by phone. Please call 812.353.9101 or toll free at 877.353.9101, Monday through Friday, between the hours of 8 am to 7 pm, and we will be glad to assist you. Your questions are welcome.

Please submit this online information at least two business days prior to your scheduled visit or three weeks prior to your expected delivery date. This allows us adequate time to verify and pre-certify your insurance (if applicable).

By pre-registering, you are able to report directly to your service area. You will not need to visit our Patient Registration area.

You will need the following items to complete this process:

  • The date of your scheduled test or procedure, or your expected due date.
  • Your insurance card or Medicare/Medicaid information, if applicable.
  • An e-mail address.

You will need to bring the following with you when reporting to the hospital:

  • A list of all your current medications.
  • All written orders from your physician/provider that have been provided to you.
  • Insurance card(s).
  • Any applicable referrals or authorizations.

The information you submit is transmitted via secure 128-bit encryption. IU Health Bloomington Hospital respects your right to privacy and confidentiality.

Please note you cannot stop in the middle of this registration and save it for later completion. Please allow 15 to 20 minutes of your time to complete this online form. To protect your privacy, no information is saved until you click the submit button and transmit it to Bloomington Hospital.

If information is incomplete, or needs further clarification, registration staff may need to follow up with a phone call. If we cannot reach you, you may be asked to report to the Patient Registration area when you arrive.

Click “Pre-register Now” below to be taken to our secure pre-registration form.
PRE-REGISTER NOW