Newton-Wellesley Hospital :: Patient Information

Online Pre-registration is NOT available for appointments that are less than 24 hours from now. This is to ensure there is adequate time to process the registration and avoid patient delays or inconvenience on the day of your visit.

To pre-register for appointments that are scheduled or planned for tomorrow or the next business day, please call 617-243-6122.

Online Pre-registration is available for ancillary services only and is not available for Maternity and Surgical patients.
Maternity patients: Please fill out your pre-admission form and mail it to the Hospital.
Surgical patients: Please call 617-243-6122 to pre-register.

Frequently Asked Questions

Patient Information Insurance/Contact Info Visit Info

* = Required Field

* I have read and agree to the HIPAA Guidelines.

* I am pre-registering more than 24 hours before the appointment.

* I give permission to Newton-Wellesley Hospital to contact me by email regarding this pre-registration.

Patient Information

First Name: * MI:
Last Name: *
Address: *
City: *
State: * Zip: *
Phone: *
Work/alternate phone:
Email: *
Confirm email: *
Gender: * Male Female
Other legal names:
Marital Status:
Date of Birth: * (format "MM/DD/YYYY")
Social Security Number (Last 4):
Religious Preference:

Ethnicity:

Employment Status: *
Occupation:

Employer

Company:
Address:
City:
State: Zip:
Phone:

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