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Registration Information

Welcome to Fawcett Memorial Hospital. We are pleased that you have chosen to receive medical services from our facility. We are committed to making your hospital visit as comfortable and convenient as possible.

When you arrive at the hospital, please report to the Registration Department, located on the first floor. You will be asked to complete all required forms and receive a room assignment. In the case of an elective admission, the pre-admission unit of the department will make every effort to contact you in advance to obtain information to speed up the admitting process.

Registrations Requirements:

Upon arrival in the Registration department, you will be asked to verify all demographic and insurance information. You will be required provide the following information:

  • Health insurance cards and information including address, telephone number, and policy number
  • Photographic identification card
  • Social Security card
  • A valid prescription or physician order for all tests
  • Referral or authorization numbers, if required by your insurance

You will also be required to sign the Conditions and Consent for Treatment form at the time of registration. Medicare recipients will also be asked to complete a Medicare Secondary Payer Questionnaire and sign an Important Notice from Medicare form.

Hospital Payment and Billing Consideration

Patients are responsible for all financial liabilities including co-payments, deductibles, and out-of-pocket expenses at the time of registration or at the time of discharge for emergency admissions. If the exact dollar amount has not been determined, you will be asked to pay the estimated amount and will be billed for the remainder.

Pre-Registration

Pre-registration is available to all scheduled patients prior to the date of service to expedite the check-in process. During the pre-registration process, all registration information is obtained over the telephone. When you arrive at the facility, you will be required to provide your insurance cards and sign the required forms before going to the department.

Patient Rights & Responsibilities

We believe that you have the right and responsibility to be an active participant when making decisions regarding your health care. The care that you receive as a patient depends, in part, on your participation and actions as a patient in the hospital environment.

Click Here for our Patient Bill of Rights
Click Here for Patient Responsibilities
Click Here for our Notice of Privacy Practices



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Fawcett Memorial Hospital
21298 Olean Boulevard
Port Charlotte,  FL  33952
Telephone: (941) 629-1181

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