Online Pre-Registration

In order to make your visit as efficient as possible, we encourage patients to pre-register online for all services. Once registered, patients can be assured our professionals will be prepared for their visit, enabling them to complete their visit and checkout without delay. For insurance verification purposes, it is recommended that this form be submitted at least three days prior to your expected admitting date. Click here to register online.

All patients need to stop by their designated registration area to complete the registration process. Patients are expected to pay all deductibles, coinsurance or copayments at the time of service.

Pre-registration Disclaimer

If you elect to electronically submit a completed Pre-registration Form or any other information to Queen of the Valley Medical Center through this web site, you agree that you do so at your own choice and risk, and that you assume all responsibility for any liability arising from such electronic submission and from any errors or omissions in the data you provide. You agree to release and hold Queen of the Valley Medical Center and its affiliates (including its directors, officers, employees, shareholders, agents and representatives) harmless from any and all liability or cause of action arising from the interception, access or use by a third party of any information submitted electronically by you through this web site and from any errors or omissions in the data you provide. Additionally, the provision of any information to Queen of the Valley Medical Center by you through this web site, including a completed Pre-registration Form, does not create or constitute any relationship between you and Queen of the Valley Medical Center, its affiliates, or any of the physicians on its staff, to which any privilege may attach.

If you experience any problems with online pre-registration tool, please contact us at 707-252-4411 x4075