Registration
When you are having a procedure done at Columbus Community Hospital, or receiving other services here, you will be asked to go through our registration process.
Please bring the following materials with you when you register at CCH:
Registration Information
- Insurance information
- Doctor’s order/doctor’s name
- Photo ID (driver's license)
- Social Security Number
- Emergency contact information
- Registration form
Insurance Information (if applicable)
- Insurance identification card
- Medicare card
- Medicaid card
- Share of cost form
- Every Woman Matters form
- Medically Handicapped Program letter
Liability Information (if applicable)
- Workers’ Compensation paperwork
- Employer's address
- Auto/Liability information
- Date and time of accident
- Attorney representing case
As part of the registration process, you will also be asked to complete and sign the following
Authorization to Release Medical Records form. You can print this form at home and bring it with you to your visit, or you will be given a copy at CCH when you register.
In the registration process at CCH, you will also use the PatientSecure® patient identification system. For more information on this cutting-edge technology, visit the
PatientSecure® Biometric Identification System page of our website.
Contact Us
For more information on CCH’s registration process or other services offered through CCH, contact us at:
Columbus Community Hospital
4600 38th Street
Columbus, Nebraska 68602-1800
402-564-7118
info@columbushosp.org