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Hospital Pre-Registration Form


Welcome to Beatrice Community Hospital and Health Center's pre-registration site! We are happy you have chosen us for your health care needs and look forward to serving you.


Completing this pre-registration form will reduce the amount of paperwork you will be asked to fill out during registration when you arrive at the hospital.


Pre-registration is a function performed by Patient Registration within our Patient Financial Services Department. Please contact us if you need assistance with completing this form. Between 8 a.m. and 5:00 p.m., you may call us at 402-228-3344.


Upon your arrival at Patient Registration, we will obtain all necessary signatures and scan your insurance card(s). We will need to review your insurance card(s) to verify coverage and to determine if pre-certification is required. A photo ID is also needed to verify your identity.


Thank you for choosing Beatrice Community Hospital and Health Center!


Click here to open and print the Hospital Patient Pre-Registration Form.

Hospital Pre-Registration Form



When completed, you may submit the pre-registration form by:
Mail: Beatrice Community Hospital and Health Center
P.O. Box 278
4800 Hospital Parkway, Beatrice, NE 68310


Fax: 402-223-6559


Scan to your computer and email:


If you have any questions or wish to confirm that we have received your pre-registration form, please call 402-229-3344.



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This website is for informational purposes only and not intended as medical advice or a substitute for a consultation with a professional health care provider.
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