Registration for admission to hospital
Information required for any appointment or admission:
- Full legal name
- Date of birth
- MCP or out-of-province health card number
- Mothers name
- MCP expiry
- Home address
- Phone number
- Next of kin
- Person to notify
- Attending physician
- Family physician
- Appointment notification preference (phone, email or text)
- Name, address and phone number of any additional specialists you are seeing such as cardiologists, nephrologists, respirologists.
In addition to the collection of the registration information above, the following information will be requested upon admission to the hospital and recorded on an ‘Admission to Hospital Consent’ form:
Release of information
- Authorization to release information that the patient is an inpatient and their room location if a member of the public inquires.
- If a pastoral care or chaplain visit is welcomed during the patients stay and if so, what religion.
Hospital accommodations: private, semi-private or ward
- Registration staff will inform the patient of the cost and insurance coverage. Some extended health insurance covers all or part of private or semi-private room charges. A patient can also check with their insurance provider for details prior to admission.
- A ‘Request for Preferred Accommodation’ form will be completed if private accommodations are requested. Insurance information can be provided and authorization to bill for any additional charges. Please bring along private insurance cards if applicable.
- Final room assignments are based on bed availability. Eastern Health will make every effort to provide a patient with the room type requested. A patient or insurance company will only be charged based on the final room assignment.
- Please leave valuables at home. Eastern Health does not provide storage for valuables and is not responsible for any lost or stolen items.
- For out-of-province patients registering for an in-patient stay in hospital, a ‘Declaration of Hospital Insurance Coverage’ form will be completed to identify if a patient is temporarily present in the province or has recently made a permanent move to the province.
- The out-of-province health card will be recorded along with its date of expiry so that the originating province can be billed for the health care visit.
- If the out-of-province health card is expired, the patient will be billed for the visit.
During a patient’s admission to the hospital
If a patient wishes to make changes to the decisions listed above on the ‘Hospital Admission’ form at any time during their stay, the ‘Hospital Admission’ form must be updated and given to a nursing staff member to update in our electronic health record system (Meditech).