• pre-registration-form
  • maternity-pre-registration-form




Pre-Registration - Hospital Patients

For patients with scheduled appointments at one of our Hospital locations, we invite you to use our online Hospital Pre-Registration form to aid in expediting your registration process. If your appointment is today or tomorrow, we ask that you bring the completed form with you. Otherwise, please complete the Pre-Registration form and fax or mail to:

  • Central Insurance Verification Department,
  • Cape Coral Hospital
  • 636 Del Prado Blvd.
  • Cape Coral, Fl. 33990
  • Fax: 239-424-4049

If the patient is covered by insurance, please send copies of the front and back of insurance cards, if available. Once we receive the completed forms our Central Insurance Verification staff will begin the pre-registration process. If we have questions regarding the information provided we will contact you directly.

Pre-Registration - Maternity

For our Maternity patients we also offer Pre Registration prior to your expected delivery date.

Please complete the Maternity Pre-Registration form and fax or mail to the address located at the top of the form. If the patient is covered by insurance, please send copies of the front and back of insurance cards, if available. Many insurance plans require pre-authorization for your admission for the delivery of your baby.

Check with your employer’s benefits office or insurance company customer service representative to make sure that you have met their notification requirements.

If you are unable to complete the pre-registration forms in advance, you and your support person will need to allow extra time to complete the registration process when you arrive at the hospital.

Please bring your photo ID and insurance cards.