How Do You Complete Medical Admissions Form?


Quick Answer

To complete most medical admissions forms at a hospital, a patient must enter pertinent information, including full name, birth date, mailing address, insurance data and emergency contact name. If a patient is admitted for a pre-scheduled surgery or other medical procedure, then he should also bring to the hospital some form of identification, insurance card, Medicare or Medicaid card, Social Security number, list of medications and any physician's referral forms, as noted by Johns Hopkins Medicine.

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Full Answer

Overlake Medical Center and Shore Medical Center are institutions that provide online pre-admission forms that patients can fill out prior to going to a hospital for a procedure. Filling out these forms is a relatively easy process. However, prior to admittance into a hospital, the patient also may need to undergo pre-admit testing, as noted by Overlake Medical Center.

  1. Fill out the patient and personal sections of the form
  2. Enter the patient's first, last and middle name on the form. Add the patient's marital status, birth date, gender, race, Social Security number, full address, city, state, telephone number and e-mail address. Fill in the treating physicians name, address, phone number, admission date and reason for hospital stay if the form asks these questions.

  3. Provide insurance, employer and emergency contact information
  4. Fill in the the requested data for the primary and any other additional insurance that the patient may have. Write in the patient's employment status and position and add contact name, which can be a family member or friend. Include any other data requested, including those related to conditions, disabilities and workers compensation. Sign the form if a signature is required.

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