Hospital Registration Form – Fill Out and Use This PDF

Hospital Registration Form is an essential document for those seeking hospital care. It provides basic information needed to ensure seamless and personalized care. Essential information required to register in a hospital may include personal details such as name, date of birth, address, contact information, insurance provider and policy information, etc. Completing the Hospital Registration Form allows the hospital staff to gather this important information and create your unique medical record. With an accurate registration form, your treatments will be managed better based on recorded medical history, allergies, current medications, existing conditions or order tests that are suited for you. Make sure you alwayssubmit updated details whenever necessary for an uninterrupted healthcare experience by completing the registration form with accuracy.

Hospital Registration Form PDF Details

Do you dread your next hospital visit, knowing you have to fill out more paperwork? If so, you’re not alone. Every year millions of Americans spend time completing their hospital forms and documents over and over, leaving them feeling frustrated and overwhelmed by the process. Fortunately, hospitals are working hard to simplify this experience with digital registration solutions that reduce the stress of paperwork. In this blog post we’ll break down how a digital hospital registration form works, who it benefits most and provide tips on how to make sure your information is secure.

Question	Answer
Form Name	Hospital Registration Form
Form Length	4 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min
Other names	form c hospital registration certificate, hospital registration certificate download for medical, hospital registration certificate download, hospital registration online

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Registration Form

Only one child per form

CHILD’S PERSONAL INFORMATION

Surname First name Preferred name Middle name

Boy Girl

Date of birth Religion Nationality

Proposed year of entry

PARENT’S / GUARDIAN’S DETAILS

Year group at entry: (please tick as appropriate)

Year 7	(11+)	Year 8	(12+)
Year 9	(13+)*	Year 10	(14+)

Year 12 (16+)

*13+ candidates only. Will he or she be a Common Entrance candidate?

YesNo

Boarding place		Day place

Every pupil whose parents are resident abroad must have a guardian in this county.

Please tick Parent / Guardian box to indicate to which address correspondence should be sent.

Parent / Guardian 1

Title Initials First name Surname Relationship to child Relationship to Parent / Guardian 2

Occupation Address

County

Postcode Country

Day Tel Eve Tel Mobile Tel Fax No Email Former pupil of the Royal Hospital School?

Yes No

Parent / Guardian 2

Title Initials First name Surname Relationship to child Relationship to Parent / Guardian 1

Occupation Address

County

Postcode Country

Day Tel Eve Tel Mobile Tel Fax No Email Former pupil of the Royal Hospital School?

Yes No

CHILD’S PRESENT SCHOOL

School Name Type: Independent / Maintained (delete as appropriate)

Name of Head: Title Forename Surname Address

Postcode

Country

Telephone Number

Fax Number

Email Address

May we contact him / her? Yes

SIBLINGS

Does your child have any siblings currently in the school?

Yes	No	If yes, please give names, year and house.

Does your child have any siblings that are former pupils at the school?

Yes	No	If yes, please give names.

Do you have any other children for whom you may consider the Royal Hospital School in the future?

Name		Name


DOB		DOB


Year of entry	Sex	Year of entry	Sex

ADDITIONAL INFORMATION

Does your child have any Special Educational Needs (SEN) or physical or learning difﬁculties?

Yes	No	If yes, please attach a conﬁdential covering letter or
Yes	No	educational physcologist’s report.


Would your child require EFL (English as a Foreign Language) lessons?
			Yes	No
If yes, please state child’s ﬁrst language
If yes, please state child’s ﬁrst language

INTERESTS

Please give details of any extra-curricular interests your child has, including sports.

OTHER APPLICATIONS

Have you registered your child with any other school?

If so, where?

HOW DID YOU FIRST HEAR OF THE SCHOOL?
Please tick box	Word of	Present	Open

or give details.
	mouth	School	Day

Education Agent

Exhibition

Schools’ listing / Directory

Advertisment Other website

Newspaper or Magazine

FEES

Yes No

School

websiteBanner

It is assumed that School accounts will be sent to the person signing the contract which is issued on acceptance of a place at the School. If this person is different from the correspondence address please state.

Please send all fee information to:

Parent / Guardian 1

Parent Guardian 2

Other (see below)

Title

First Name

Surname

Address

Post Code

Tel No

Fax No

Are you eligible for MOD Continuity of Education Allowance (CEA)?

Yes

Name of claimant and service

Do you wish to apply for a Greenwich Hospital Seafarers Bursary?

Yes

(please see the General Information Book for conditions of eligibility)

If yes, you will be sent a Bursary Application Pack.

DECLARATION

This form should be returned to the Admissions Ofﬁcer, The Royal Hospital School, Ipswich, IP9 2RX, together with the non-refundable Registration Fee of £75 and a copy of your child’s Birth Certiﬁcate. Places are conditional upon passing the Entrance Examination, interview at the school and receipt of a satisfactory report from the Head of the child’s present school. Fees are payable each term in advance, and a term’s notice in writing must be given before a pupil is withdrawn from the school.

I / We request that the above named child be registered as a prospective pupil. We understand this registration form does not give rise to a commitment by the school or the parents and that the offer of a place is subject to availability and the entry requirements of the School at the time of offer.

I enclose a cheque for £75 (payable to ‘Royal Hospital School’)

or agree to make a transfer payment to the Royal Hospital School

Bank Name:	HSBC Bank plc
Account Sort Code:	40-07-13
Account Number:	71599682
IBAN:	GB40MIDL40071371599682
SWIFT Code:	MIDGBL22

Please ensure that your child’s name is quoted as a reference.

First Signature	Second Signature

Name in Full	Name in Full

Relationship to Child	Relationship to Child

Date		Date

The Royal Hospital School, Holbrook, Ipswich, Suffolk. IP9 2RX

Tel: 01473 326 200 Fax: 01473 326 213 Email: admissions@royalhospitalschool.org

The Royal Hospital School is registered as a Data User under the Data Protection Act 1984 and our use of personal information is notiﬁed to the Information Commissioner as we are required to do under the Data Protection Act 1998. The Royal Hospital School has no separate legal identity from that of Greenwich Hospital and therefore, for the purposes of the Data Protection Act, is synonymous with the Hospital. The information which you provide to the Royal Hospital School on this Application Form will be used for processing your application, determining eligibility for a Greenwich Hospital bursary, and for statistical purposes. Any information which you provide to the Royal Hospital School may be disclosed on a conﬁdential basis to departments or individuals of Greenwich Hospital by the Royal Hospital School but will be done so in keeping with the Royal Hospital School’s obligations under the Data Protection legislation when necessary. The School will ensure that all personal information is held securely and is not accessible to unauthorised persons.

Hospital Registration Form – Fill Out and Use This PDF

Hospital Registration Form PDF Details

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