Patient Pre-Registration

If you have a test or procedure scheduled at Mahaska Health Partnership, please fill out this form in its entirety. All fields marked with an asterisk(*) are required.

If you have questions, call 641-672-3100.

Online pre-registrations are checked M-F 7:00-4:30. Allow one business day for your registration to be processed.

*Date of Visit:
*Appointment Time:
:
*Where will your visit/procedure take place?:
*If you are hospitalized, can we make your name available on the hospital directory?:
 
Yes No
 
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