Labor & Delivery Pre-Registration Form Dear Patient, Thank you for choosing Rush-Copley Medical Center for your delivery. In order to provide you with the most efficient registration on the day.
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How to fill out the Printable Pre-registration Form - Rush-Copley Medical Center online
Completing the Printable Pre-registration Form for Rush-Copley Medical Center is an important step towards ensuring a smooth admission process for your delivery. This guide will provide you with clear, step-by-step instructions to help you efficiently fill out the necessary information.
Follow the steps to complete the Pre-registration Form efficiently.
- Click ‘Get Form’ button to access the Printable Pre-registration Form and open it for editing.
- Begin by entering your personal information in the 'Patient Information' section. This includes your last name, first name, middle initial, birthdate, social security number, marital status, race, expected due date, age, home address, county, home phone number, and cell phone number.
- In the 'Employment Information' section, provide details about your employer including the employer's name, address, phone number, and your occupation.
- Next, complete the 'Spouse/Baby's Father Information' section. Enter the last name, first name, middle initial, birthdate, social security number, home address, county, home phone number, cell phone number, and relationship to the patient. Additionally, fill out the employer's name, address, phone number, and occupation.
- In the 'Patient's Financial Information' section, ensure you attach a copy of your insurance cards. Input the insured name, relationship to patient, name of the insurance company, identification number, group number, and the insurance company phone number.
- Complete the 'Patient's Physician Information' section by entering the names of your primary care physician, baby's pediatrician, and OB/GYN.
- Consider your breastfeeding preferences and select the appropriate response. Indicate whether you plan to breastfeed your baby and if your healthcare provider has educated you on the benefits of breastfeeding.
- Review all entered information to ensure accuracy. Once completed, save your changes. You can then download, print, or share the form as needed.
Ensure a seamless admission process by completing the Printable Pre-registration Form online today.
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What is the phone number for Rush University Medical Center medical records?
Appointments and medical records MyChart: For online prescription refills, test results and appointment scheduling for current patients, call (312) 563-6600 or log in to your MyChart account. Medical records: To request copies of your medical records, please call (312) 942-7262.
What type of hospital is Rush University Medical Center?
RUSH University Medical Center is an academic medical center that includes a 671-bed hospital serving adults and children, the 61-bed Johnston R. Bowman Health Center and RUSH University. For more than 180 years, the Medical Center has been leading the way in developing innovative and often life-saving treatments.
What is the fax number for Rush University Medical Center medical records?
Please address questions about this form to: Rush University Medical Center, ATTN: Health Information Management Office, 1611 West Harrison Street, L1, Suite 001, Chicago, IL 60612, Telephone: (312) 942-7262, Fax: (312) 942-2264.
Why do you want to work for RUSH Hospital?
A destination for top health care talent, RUSH exemplifies a team-based culture in which the outcomes are among the nation's best. Become part of an internationally renowned academic medical system that puts one goal above all others — providing outstanding care.
Does RUSH hospital have an app?
The My Rush app provides mobile, on-the-go access to your health record so you can manage your care on a single, secure platform.
What is the Rush Copley alternative birthing suite?
About Rush Copley Alternative Birth Suite Our large room also includes a queen-size bed so you and your partner can bond with your baby after birth. Special laboring items and equipment: Our suite includes a birthing sling and a birthing seat, both which use gravity to encourage the descent of your baby during labor.
How to get medical records from Rush University Medical Center?
Please contact the Medical Records Department with any questions. Address: Medical Records Department, 520 S. Maple Ave., Oak Park, IL 60304. Office phone number: (708) 660-4000. Record request phone number: (312) 942-7262. Monday through Friday: 7:30 a.m. to 4 p.m.
How do I schedule an appointment at Rush University Medical Center?
New patient appointments: To make an appointment as a new patient, please call (888) 352-RUSH (7874). MyChart: For online prescription refills, test results and appointment scheduling for current patients, call (312) 563-6600 or log in to your MyChart account.
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