Elliot Health System is a non-profit organization serving your healthcare needs since 1890.

 

Welcome to Pre-Registration

For your convenience, please complete your information to assist us in processing your registration before your arrival. If you have used Elliot services within the last thirty days and your information has not changed, just fill in your name, date of birth, date of upcoming appointment and the physician who is ordering your service.

Your registration will be processed prior to your appointment. Please complete your online registration 24 hours prior to your arrival. Or for same day pre-registration call our Elliot Express Registration at 603-663-3030. This service includes Laboratory Services.

For assistance with your pre-registration, call the Pre-Registration Office at 603-663-5663, we are happy to assist you.

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Name
Address

Male Female

Place of Birth

The State of New Hampshire mandates the hospital to request this information.

Employer Info
Your Family Physician

(A Family Physician is your family doctor that you normally go to visit when you fall ill.)

Yes No