OB Preregistration Form

To our prospective maternity patients:

Congratulations! We are pleased that you and your physician have chosen Asante for your maternity care. We will do everything possible to make your stay pleasant and comfortable.

Before your due date:

In order to ensure your smooth and speedy admission, we ask that you complete this confidential questionnaire in full. We are happy to bill your insurance for you provided you complete the necessary information on the questionnaire and provide us with a copy of your insurance and/or Medical cards prior to your admission to the hospital. We recommend that you contact your insurance company to ensure that you have complied with any pre-notification requirements it may have. If you have not met your deductible or do not have insurance, please contact our Patient Financial Counselor at (541) 789-4111 to make payment arrangements.

What to bring: 

Be a light traveler. Bring only those personal items you need such as cosmetics, robe and slippers, etc. that will make your stay more pleasant. You may bring your own nightwear if you wish. Don’t forget a going home outfit and blanket for your new baby. 

We ask that you leave valuables at home. $5 to $10 cash should be sufficient for your personal needs. If you must bring valuables, they may be deposited in the hospital safe for your protection. The hospital cannot assume responsibility for items taken to your room or bedside.

While you are here:

Due to normally short hospital stays, we recommend that you limit visitors to allow more time to rest and bond with your new baby. Please ask your visitors to respect others by keeping noise to a minimum. 

Asante is completely tobacco-free, including all buildings, our grounds, parking lot and any vehicles on our properties. For your safety, patients are not permitted to leave the hospital to smoke or use tobacco products. There are resources available to make you more comfortable during your stay. Please contact your physician for further information.

When you are ready to leave:

Please be familiar with the operation of your infant seat and have it brought to the hospital at the time of your discharge for your baby’s safety and in compliance with state law, we encourage all new parents to provide approved car seats for their infants.

We look forward to meeting you!

OB Preregistration Form