You can speed up your registration upon arrival by pre-registering online. Please enter the information requested on the following pages as completely and as accurately as possible. It will take you about 5 minutes to complete this form. Form needs to be completed two business days prior to admission.
Remember, that upon your arrival at Sanford Sheldon, you will be asked to verify your registration information; a copy of your insurance card will be made, and you will be asked to sign authorization forms.
NOTE: Any information collected during the online pre-registration process is protected for your privacy and confidentiality.All information submitted is a confidential part of your medical record. This is a secure section of the web site where your information is kept secure and private.
If you have any questions concerning the completion of this form, please call (712) 324-5041.