CHI St. Luke's Health Emergency Rooms

ER Patient Registration Form

This downloadable Emergency Patient Registration Form is used for quick identification purposes only. This form may be presented at one of the Baylor St. Luke's Emergency Centers or main hospital campus Emergency Departments.

Due to the nature of emergency services, patients are seen in order of medical need and not the time of arrival. It is helpful for any registration to have photo identification of the patient with you, for example, a Drivers License, if available. If you wish to use medical insurance, bring a current insurance identification card as well. If a child or minor is the patient, having the minor's Social Security Number helps ensure correct identification for this and future visits. Emergency Room CoPay or CoInsurance is required by most insurance plans. Amount varies based on your plan.

Download the Patient Registration Form and fill it out before you arrive.

Our Emergency Departments

Our Community Emergency Centers

Featured Updates

9 Toys To Avoid Giving This Year for the Holidays

DEC 15, 2020

Our pediatricians provide parents with tips about toy safety this Christmas. Choose safe toys this holiday season, and locate your nearest emergency room just in case.

Read More Additional information about 9 Toys To Avoid Giving This Year for the Holidays

How To Know When To Visit the ER for a Heart Attack Heading

NOV 12, 2020

Heart attack symptoms can vary. Be sure to know the signs, and seek ER care immediately if you believe an attack is happening.

Read More Additional information about How To Know When To Visit the ER for a Heart Attack | St. Luke's Health

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