The Home Tonight
Advance Registration

Your advance registration form is enclosed. The form is two-sided and asks for information about you, as well as about your insurance. Much of this information is required by New York State regulations, so it is important that you fill the form out completely.

Insurance Information

Include all information
Fill out only the insurance information that applies to you and your coverage. If you (or your spouse) have several types of coverage, please include all information. If possible attach a photocopy of your insurance cards. This will speed your pre-admission process.

Be sure to obtain pre-admission certification
Your insurance plan or employer may require pre-admission certification (prior approval) for a hospital stay. If so, it is your responsibility to obtain necessary approval. Please check with your employer or insurance carrier in advance regarding any requirements you must meet to obtain coverage.

If you need a sign language interpreter
If you would like the services of a sign language interpreter, please call the Admitting Department at 492-5538 or note your request on your Advance Registration Form. We will provide an interpreter at no cost to you.

Questions?

• About your insurance coverage or pre-admission certification? Call our Business Office at 492-5555.
  
• About the Advance Registration Form? Call the Admitting Department at 492-5538.

Mail your completed form in the enclosed, postage-paid envelope.