Columbus Community Hospital

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Home > For Patients & Visitors > Registration
  • About Us
  • Antibiotics Awareness
  • Bike Share
  • Cafeteria
  • Charging Stations
  • E-Cards
  • Find a Physician
  • Healthcasts
  • Interpreter Services
  • Gift Shop
  • Joint Commission
  • Medication Safety
  • Nominate a Nurse
  • Nominate a Noncertified Nursing Employee
  • Non-Discrimination and Language Help
  • Online Bill Pay
  • Patient and Family Advisory Council
  • Patient Financial Information
  • Patient Portal
  • Pathway to Excellence Designation
  • Physician Directory
  • Pre-Admission
  • Price Estimator
  • Registration
  • Social Media Policy
  • Valet Parking
  • Visiting Hours

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

© 2022 Columbus Community Hospital, Inc.
4600 38th Street
P.O. Box 1800
Columbus, Nebraska 68602-1800
T: 402-564-7118
E: info@columbushosp.org

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