On-Line Registration

Click Here - to complete the on-line registration process

Please note, once you are scheduled for surgery, it is important to complete your on line registration/pre-operative screening as soon as possible.

♦    Try to complete this right after your leave your surgeon’s office after scheduling the procedure.

♦   You will be provided a small business card from the surgeon’s office which depicts access information.

Please allow yourself 30-40 minutes of uninterrupted time to complete the registration. Have a listing of  your current medications, allergies and past surgeries for ease in entry of the information. You must complete the form in entirely all at one time.

♦    Enter the password of:  ASC500NEW

♦   Complete the medical history form and press SUBMIT when finished.

♦    After submitting, you will be offered to print out the form for yourself.  

♦    If you have trouble accessing the form to complete, please call 877-848-4726 for Customer Service or contact our office at 715-345-0500.