Pre Registration

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

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.

Click here to fill out the Secure Online Pre-Registration Form
(Please use Internet Explorer 6.0 or higher)

Pre-Registration via Mail

Download and complete the Adobe Acrobat Online Pre-Registration Form and mail it to Mission Registration at:

For insurance verification purposes, you must mail your Pre-Registration Form at least two weeks prior to your expected admitting date.

The Adobe Acrobat application requires the Adobe Acrobat Reader. If you can't open the Adobe Acrobat document or are having trouble viewing it, click here to download the free Adobe Acrobat Reader.

Click here to download the Pre-Registration Form (pdf)

Pre-Registration via Phone

You can call Mission Main Registration at (949) 364-1400 ext. 1810 (Mission Viejo) or (949) 499-1311 ext. 7167 (Laguna Beach) and ask one of our registrars to pre-register you over the phone. If a registrar is unavailable, please leave a voicemail and your call will be promptly returned.

Pre-Registration via Fax

Download and complete the Adobe Acrobat Online Pre-Registration Form and fax it to Mission Main Registration at (949) 364-4842 (Mission Viejo) or (949) 499-1311 ext. 7529 (Laguna Beach). For insurance verification purposes, it is recommended that you fax the registration form at least three days prior to your expected admitting date.

Click here to download the Pre-Admission Form (pdf)

If you have any questions about our Pre-Registration Forms please call your designated registration office.