Registration

Hours of Operation:    
Emergency Department Registration:
7 days per week, 24 hours per day

Front Lobby Registration: 
Monday-Friday 7:30 a.m.–4:00 p.m.  

Phone numbers:    937-386-3804
                            937-386-3805
                            937-386-3811
                            937-386-3812       

Fax number:         937-386-3829

The Patient Registration Department obtains the necessary patient information for all admissions/registrations including:
·         Emergency Room                  
·         In-Patient                   
·         Lab
·         X-ray
·         Cardio pulmonary
·         Outpatient clinic
·         Same Day Surgery
·         Diabetic Education
·         Cardiac Rehab  

When presenting at the Registration Department for a test or procedure we will need a signed physician’s order with the following information:
·         Patient’s name
·         Type of test/procedure
·         Diagnosis
·         Physician’s signature
·         Date  

The Registration Department will also request the following information from you when you are registering for any services:
·         Insurance, Medicare and/or Medicaid card. 
·         Drivers license or other photo ID  

Patients must be 18 years of age to register and sign for treatment or services.  Patients under 18 must be accompanied by a parent or legal guardian.  

In the event that the parent or legal guardian of a child cannot bring their child to ACRMC for treatment or services an Emergency Contact and Medical Information for a Child form must be completed, signed and dated by the parent or legal guardian and presented at the time of registration. 

The Emergency Contact and Medical Information for a Child form is available in the Registration Department or you may download and print a copy below.

Locations offering this Department

Main Location
230 Medical Center Drive
Seaman, OH 45679
Ph: 937-386-3400

Department Test, Preps and Other Documents

Additional Documents

Hours of Operation

Emergency Department Registration 7 days per week, 24 hours per day Front Lobby Registration Monday-Friday 6:30 a.m. – 8:00 p.m.

Special Hours

Special Notes about this Department

Phone numbers: 937-386-3804, 937-386-3805, 937-386-3811 & 937-386-3812