Online Patient Registration Help

Online Patient Pre-Registration

This process can be completed online at our Pre-Registration Page. If your appointment is within 24 hours, please use phone pre-registration: 812-375-3718 or 1-800-841-4938 ext. 3718. Phone registration is available Monday - Friday from 9 AM - 8 PM.

If you still require help, please complete the form below

To continue to provide the best information and service to you, please take a moment to fill out this contact form. Please provide the needed contact information in order for a response to be returned in a timely manner. 

Please note that this form is for patient registration help only. Help with registration for CRH or WellConnect events, such as Lunch and Learn, should submit a question here.