Open Accessibility Menu


Online Pre-Registration Form

Welcome to UF Health Flagler Hospital’s online Patient Registration portal. We want to thank you for choosing UF Health Flagler Hospital for all of your health care needs. You may pre-register by completing our on-line registration form at least 2 business days (48 hours) in advance of your scheduled service.

Your information will be sent directly to our facility in a secure format. Online pre-registration is available for inpatient and outpatient services, including diagnostic testing. Outpatient Surgery and Labs are excluded.

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 appointment. For any questions regarding this process, please call 904-819-4640 during normal business hours Monday through Friday 8:00 am - 5:00 pm.

What you will need to pre-register:

  • Your name, address, phone number
  • Emergency contact information
  • Insurance information
  • Ordering doctor and primary care doctor
  • What date you will be arriving for services
  • What type of visit, procedure, or test

Pre-Registration Form:

  • Make sure all required fields (*) are filled in.
  • If a required field does not apply to you, type in "NA" or "Not Applicable."
  • Fill in as many fields as possible so we can best prepare your registration.

Click here to proceed to Pre-Registration

For questions regarding pre-registration, feel free to email: