Patient Pre-Registration Form for Ascension Saint Thomas Rutherford
Thank you for choosing to Pre-Register with Ascension Saint Thomas Rutherford. We look forward to serving you on your upcoming visit to our facility. You can use this secure electronic pre-registration form to submit all of your registration information to us prior to your visit which will speed up your check-in process on the day of your procedure / test. Once we have received your information, we will pre-register you and verify your insurance benefits for your visit. One of our associates from our Pre-Services Team will attempt to contact you prior to your visit to go over your specific insurance information if we estimate you will owe any out of pocket expenses.
If your date of service is less than 48 hours from now, please do not use this on-line pre-registration form but contact us by phone at 615-396-5525. In addition, should you have any registration or insurance questions prior to service please contact us at the same number above.
Thank you for choosing to Pre-register with Ascension Saint Thomas Rutherford!