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Pre-Registration Patient Questionaire

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As a convenience for patients, Salem Hospital is pleased to offer online hospital pre-registration. You will need this information to complete your pre-registration:

  • Your insurance card
  • Referral form or letter, if appropriate
  • Information about your doctors, including names and addresses
  • Emergency contact information
  • We may need to contact you if any of the insurance or employer information is incomplete.

  Online Pre-registration Form

If you have a scheduled procedure or appointment at the hospital within the next 24 business hours, please call our Pre-Admission Staff with this information at 503-561-5357.