hospital registration form

According to a study conducted last 2016, the third leading cause of death in the hospital is medical error; next to heart disease and cancer. There are a number of reasons for medical error. While one could blame incompetent medical practitioners for this, medical error could also be a result of poor communication, illegible handwriting and improper documentation. The patient’s personal information and previous medical records are vital in obtaining the right diagnosis of the patient.

The form which can is used for writing and collecting the personal data of patients and hospital clients is known as a hospital registration form. This document aids the staff of the hospital in acquiring an in-depth record of their patients. By having the form, the staff will be able to assign unique patient identification numbers so that they can cater the required services of the patient which will be accessible to the authorized physicians.

Hospital Meeting Registration Form

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Size: 173 KB

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Varieties of Hospital Registration Forms

Animal Hospital Registration Form – This form is for the clients in an animal and veterinary hospital or clinic. The form will mainly focus on the general information of the pet owner which includes the name of his spouse, his contact numbers, and his employer’s name and company. After the section for the pet owner’s information, a responsibility and liability agreement is found on the form. This is to assure that the pet owner will be claiming and holding his responsibilities for his pet including the payment for the hospital fees and cost of the pet’s treatments.

Animal Hospital Registration Form

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Size: 142 KB

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Church Hospital Registration Form – Some churches, ministries, and religious groups have their own medical centers for the benefit of those in need as well as their members or their families. This church hospital registration form will state the name of the facility who recommended the patient to the medical institution. The patient information is the center of this document which will have the patient’s name, gender, social security number, date of birth civil status, and address. The patient may also indicate the medical plan where he is enrolled as a beneficiary or a policyholder to allow the medical institution in connecting with the patient’s insurance company.

Church Hospital Registration Form Sample

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Company Hospital Registration Form – Health and medical-related benefits are some of the bonuses that companies give out to their staff and employees. This is why a company hospital registration form will serve a great use for stating the particulars of the staff which may include his photo with his spouse and his children. The form should be signed by the human resources personnel of the company for approval and verification of the staff’s claim. The birth certificate forms of the staff’s children will need to be attached and submitted together with this form to show proof that the names stated as beneficiaries are indeed related to the staff.

Company Hospital Registration Form

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Size: 376 KB

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Hospital Board Benefit Registration Form – States who provide a hospitalization benefit to their miners will need this registration form. This will have the miner’s information which will include the details of his employer and the name of the mine site where he is working. Authorization and employment verification statements are found below the form to allow the company in searching through the employee’s or the miner’s records. The authorization also permits the company in using the information that the miner has stated on the form for purposes relating to employment and determining the miner’s benefits.

Hospital Board Benefit Registration Form

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Size: 123 KB

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Hospital Car Registration Form – This form is used if a patient or a hospital client wants to use the car service of the hospital for transporting towards his residence or to any location that he will request. Aside from the basic information of the person requesting the transportation, the form will also indicate the illness and will acknowledge his disability. The requesting person must state an emergency contact person with the right contact number on the form to allow the hospital staff in calling the authorized person in the event of an accident during the travel or whenever they may need additional support from a relative.

Hospital Car Registration Form

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Size: 8 KB

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Hospital Donor Registration Form – Patients who are dealing with an incurable illness often end up donating some of their organs to the hospital as a sort of help and acceptance of their death. A hospital donor registration form will cater the information of the donor, his social security number as well as the limitations that he prefers which are the organs that the hospital is not allowed to touch or remove for donation. The donated organs will then be kept in the designated storage of the hospital and will only be given to the patient who will submit a donation request to the staff for curing his ill state.

Hospital Donor Registration Form

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Size: 90 KB

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Hospital Employee Registration Form – Hiring an employee in a medical center or institution will demand the use of this registration form. Specifically, the form acts as an employee information form which will focus on gathering the significant and relevant data of the employee. The department and medical facility where the employee is assigned will also be stated on the form along with the family details of the employee such as the family size, name of parents, and the employee’s marital status. After the submission of the form, the officer in-charge of the employee will have to affix his signature to indicate the success of the registration process.

Hospital Employee Registration Form

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Size: 19 KB

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Hospital Event Registration Form – Hospitals and medical centers do not only value their patients but also their knowledge and the essence of enjoying outside activities. This is why events and conferences beyond the premises of these medical institutions are being held and conducted to promote employee and staff engagement. The hospital event registration form will have the full name of the attendee, his designation, the organization or the hospital where he is working, and varieties of registration fees for different events. The attendee must state the amount that he provided for the registration in words to assure readability and aid the event planners in recording the paid amount.

Hospital Event Registration Form

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Size: 405 KB

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Blank Hospital Registration Form – Aside from events where the physicians will take a seat and listen to the speaker, hospitals or medical institutions also conduct marathons for their employees and for the sponsors of their institution. A hospital fun run registration form will have the details of the marathon such as the schedule and the closing date for the registration. The shirt order of the participant should also be included to allow the medical institution in preparing the marathon shirts before the day of the event.

Blank Hospital Registration Form

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Hospital Providers Registration Form – This form can be used whenever a medical practitioner will be applying for a health plan. This mainly contains the personal information of the practitioner, his medical profession, his license or registration number, as well as the hospital where he is currently affiliated. Along with the aforementioned information of the medical practitioner, he is also required to indicate if he is still accepting patients or not, and the educational institution where he was able to graduate for his profession. The service addresses of the practitioner are demanded to be written on a separate sheet which may undergo an address verification to assure that his address claims are real and exact.

Hospital Providers Registration Form

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Size: 97 KB

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Hospital Registration Application Form – Compared to the other forms in this list, this document is not intended for the use of the staff but for the hospital owner. The name of the nursing home or the medical center which needs to be registered will be stated as the first entry on the form along with the description of the center. The form’s structure is similar to a medical questionnaire where a set of questions are included to determine the qualification of the hospital with regards to the standards of the country.

Hospital Registration Application Form

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Size: 80 KB

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Hospital Staff Lottery Registration Form – Hospital lottery games aim to provide enjoyment and chances of winning to the staff and members of the medical center while helping raise funds for those patients in need of financial support. With a hospital staff lottery registration form, the staff and lottery enthusiasts will be able to register for lottery games. The form will also indicate the employee payroll information of the staff such as the beginning and end dates of the staff’s pay period. The number of entries that the staff will play and register are stated on the form as to whether the staff will account for one lottery game, two or three sequences of games.

Hospital Staff Lottery Registration Form

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Size: 167 KB

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Hospital Volunteer Registration Form – Medical centers also need volunteers who will help him through their every runs in providing services to their clients and patients. A hospital volunteer registration form contains the personal data of the volunteer, his contact information, the area where he prefers to provide his volunteer service, as well as the skills and experiences which he may use for the benefit of the services. His schedule of availability is stated on the second page of the form which will aid the hospital staff in determining who will assist the volunteer on the specific days and hours.

Hospital Volunteer Registration Form

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Size: 287 KB

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With the listed varieties of hospital registration forms, an individual will be able to decide what document suites his needs for hospital-related purposes. With this, the information on these registration forms must only be used for meeting the intention of recording the data of the user, and not for illegal and unauthorized intentions.

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