Rocket Fuel
Advanced Search
Print    Email
Decrease (-) Restore Default Increase (+)
Find a Physician

Pre-Registration

If you have an upcoming appointment at Holy Cross Hospital or Holy Cross Germantown Hospital., you can save time once you arrive at the hospital by pre-registering online. Please submit the form at least five to seven days in advance of your arrival. If your scheduled visit is within five to seven days, please call our Registration Department at 301-754-8300 as soon as possible to register.

Form Instructions

Before you begin filling out this form, gather information about yourself, your physician, your employer, your insurance and the reason for your hospital visit. The information requested in this form is required by law and will help us to best address your health care needs.

All fields marked with an asterisk (*) are required. If a required field does not apply to you, enter "N/A" or "not applicable." If you have all of your information on hand, you should be able to complete this form within approximately 15 minutes. Please note that we cannot accept incomplete forms.

After you submit this form, a Holy Cross Health Patient Registration representative will process your information and will contact you if any additional information is needed. If you have any questions, please call 301-754-8300.

To prepare for your visit, please learn about our facility in our Patients and Visitors section, including information about parking, amenities and more.

Protecting your privacy is very important to us. You may view our Privacy Policy here.

 

  Holy Cross Hospital
  Holy Cross Germantown Hospital
  Icon-LinkedIn.png 
© 2015  Holy Cross Health | 1500 Forest Glen Road, Silver Spring, MD 20910 | 301-754-7000
trinity-health.org