Registration Department Information
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.
Phone numbers: 937-386-3804
937-386-3805
937-386-3811
937-386-3812
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 Treatment and Permission Slip must
be completed, signed and dated by the parent or legal guardian and presented at the
time of registration. The Emergency Treatment and Permission Slip may be obtained
from the Registration Department or you may download and print a copy.
Click here to print the Emergency Treatment and Permission Slip.