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Terre Haute Regional Hospital

Patient Registration

We want your registration process to go as smoothly as possible. That is why we have created a guide to help ease the process.

You may be required to sign the following:

  • Consent for treatment
  • Authorization to bill insurance

If you are a Medicare recipient, you will be required to sign:

  • Medicare Secondary questionnaire
  • Medicare Rights Statement

If you are a Champus recipient, you will be required to sign a Champus Rights Statement.

Remember to bring with you at the time of registration the following items:

  • Social Security Card
  • All active insurance cards
  • Picture ID
  • Living Will, if you have one

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