Pre-Register

For your convenience we now offer online pre-registration for your surgery with Simple Admit. Registration is designed to be quick and easy and completing the form should take you 15-20 minutes. Please have the following information available, as it may be needed to complete your form:

  • Prescription Medications – names and dosage of each one you take.
  • Over-the-counter Medication – names and dosage of each one you take regularly.
  • Vitamin and Herbal Medications – names and dosage of any that you take.
  • Allergies/Sensitivities you have, and the allergic reaction(s) they cause.
  • Previous Surgeries, and the year they were performed.
  • Medical Insurance – insurance company, policy number, ID number, etc.

Returning patient will receive an email with log in instructions. If you are a new patient you will be required to enter the following password: NEW971EPSC

Please call (877) 848-4726 if you need any technical assistance with your pre-registration.

Start Your Online Registration