Click here to fill out Outpatient Pre-Registration.

Wyoming Valley Health Care System is pleased to offer our patients a convenient online pre-registration option. In addition to being more convenient, registering online can save you time. This will also allow us to communicate with your insurance company to verify benefits and eligibility, ensure that appropriate referrals and pre-authorization is obtained and to resolve any insurance concerns before your admission/testing date.

Patients who pre-register will be asked to verify their information at Registration time, present photo ID for identification purposes, sign consent forms, provide copies of insurance cards and a list of all current medications.

Please pre-register at least 24 to 48 hours prior to the day of your visit to allow adequate time for processing your information.

What you will need to Pre-Register:

• Your personal contact information
• Date & time of procedure/admission
• Physician’s name
• Insurance information (carrier name, address, phone number, policy & group number)


(*)indicates a required field and cannot be left blank

You can pre-register online at any time. If you have questions and need to talk to one of our staff members, please call our pre-registration area at 570-552-1061 Monday through Friday, 8:30 AM to 5 PM or 570-552-1050, 5 PM to 11 PM.

The information you submit will be transmitted via a secure link. Wyoming Valley Health Care System respects the right to privacy and confidentiality of all patients.