We know your time is valuable, so please consider filling out this online advance registration form prior to your next visit to Geauga Medical Center. You can save time during the registration process when you arrive at the hospital for your procedure or admission.
Please note the following:
This online form is for University Hospitals Geauga Medical Center only and will not be accepted by any other hospital.
Geauga Medical Center respects the right to privacy and confidentiality of all patients. The information you provide will remain secure and used strictly for your medical record and insurance verification purposes.
You will still need to stop in the Patient Registration Department at the time of your hospital visit to sign any documentation that may be needed, in addition to bringing insurance cards and co-pays, if applicable.
If your form is incomplete or needs clarification, the Patient Registration staff may need to complete your registration either by telephone or in person when you arrive at the hospital.
Medicare subscribers are required to provide additional information in person at the time of the visit.
After you complete your form, click on the submit button and it will be transmitted via secure (128-bit encryption) e-mail to our Patient Registration Department.
This advance registration form must be received by the Geauga Medical Center Patient Registration Department at least three business days prior to your visit.
Click here to access the online advanced registration form.
If you have any questions, please call 440-285-6261 Monday through Friday from 8 a.m. until 7 p.m.