Patient Pre-Registration

Our goal is to provide information about hospital policies and procedures as well as an on-line form for pre-registration.

On-line registration is available for patients who are scheduled for Outpatient tests (i.e., Lab and X-ray) and for admission to the hospital. When you have completed and submitted the registration form, you will receive a return receipt via E-mail. You may be contacted by our admitting office if there are any questions.

If you have any questions about the information listed below or the pre-registration form, please call St. Dominic’s admitting office at (601)200-3851 and someone will assist you.


Upon arrival at the hospital at your scheduled appointment time, you will park in the parking lot or the parking garage on the north side of the hospital. You will need to check in at the information desk at the North Entrance. You will then be directed to the admitting office where you will sign papers giving permission for treatment and release of information.
It is important that you bring your insurance cards with you. The admitting staff will need to make a copy of these cards to ensure the necessary information is collected. It is your responsibility to obtain any pre-admission or pre-testing authorizations that may be required by your insurance company.

So that you may be financially prepared, you should be aware that upon admission, you will be asked to pay a deposit to cover any deductibles, coinsurance and non-covered charges. The balance of these expenses must be paid at the time of discharge.

As a courtesy to you as our patient, and according to the policy of the hospital, we will file your insurance for you at the time of discharge. We allow 45 days for your insurance company to make payment. If payment is not received within 45 days, you will receive a bill from the hospital. Payment will be expected from you at that time.

You may contact the Financial Counselor for an estimate of your financial responsibility. To speak with a Financial Counselor, call (601)200-5447.

Please bring a minimum of personal belongings with you. Please leave valuables at home. The hospital is not responsible for loss or damage to personal property.

If you are being admitted to the hospital and will be staying overnight, it is suggested that you bring a robe, slippers, sleepwear, toilet articles, and personal items such as cosmetics or shaving supplies. Please bring a current list of medications with you including name of drug, dosage and how often taken or bring your prescription bottles. With the exception of psychiatric admissions, all rooms are private and a cot is provided for overnight visitors.

If you are coming to the hospital for outpatient tests or surgery, be sure to follow any instructions given to you by your physician, i.e., no eating or drinking after midnight before the day of the procedure.