To make each visit to the hospital easier, a pre-registration form can be completed online using a secure website. This form should be completed by the 20th week of your pregnancy. This pre-registration form collects general information about your due date, your Doctor, your baby's Doctor, as well as some personal information, health insurance information, and medication information. It will also collect details about any additional insurance for semi-private or private accommodation requests that you may have during the admission process.

Childbirth Program Pre-Registration Form


date picker image

Personal Info


Patient Medication History

Taking any medications?

My Medications


Please list below any medications that you are now taking. Include PRESCRIPTION, non-prescription medications and vitamins or supplements. Other examples include: patches, inhalers, drops and medicated creams.

I will bring my medications with me

My Allergies

Do you have allergies

Feeding your baby

How do you intend to feed your baby?


Health Insurance


Substitute Decider


Aditional Insurance for Semi-Private or Private Accommodation Requests

Relationship to Subscriber

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