Patient Pre-registration

Patient Pre-registration

Welcome to our OB pre-registration tool

OB patients can pre-register by completing our online registration form at least two business days in advance of your scheduled service. Your information will be sent directly to our facility in a secure format.

Please remember to bring your insurance card and a photo ID with you on the day of your visit. All co-payments, deductibles and patient responsibilities are due at the time of service. Your insurance coverage and health benefits will be verified in advance of your patient responsibility.

You can also pre-register by calling 858-613-4660 Monday through Friday, 8 a.m. to 5 p.m. Thank you for entrusting us with your healthcare needs.

To proceed, you must consent to these terms. If not, you will be redirected back to our website:

Legal Disclaimer – If you elect to electronically submit a completed registration form or any other information to Palomar Health Medical Center through this website, you agree that you do so at your own choice and risk, and that you assume all responsibility for any liability arising from such electronic submission and from any errors or omissions in the data you provide. You agree to release and hold Palomar Medical Center and its affiliates (including its directors, officers, employees, shareholders, agents and representatives) harmless from any and all liability or cause of action arising from the interception, access or use by a third party of any information submitted electronically by you through this website and from any errors or omissions in the data you provide. (Additionally, the provision of any information to Palomar Medical Center by you through this website, including a completed registration form, does not create or constitute any relationship between you and Palomar Health Medical Center, its affiliates or any physicians on its staff, to which any privilege may attach.)

    * Required


    Marital Status:

    Mailing address:

    Phone Number:

    Spouse or Emergency Contact Name:
    Spouse or Emergency Contact Phone Number:

    Spouse Date of Birth:

    Billing type: