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Online Pre-Registration
Pre-Registration If you choose to complete our Pre-Registration form, please understand that you do so at your own choice. You also assume all responsibility for any liability arising from electronic submission or from any errors or omissions in the data you provide. Any information you choose to give will be used to submit insurance claim forms to Medicare, Medicaid and any other insurance company or payer for which you provide us information. Pre-Registration Disclaimer E-mail communication on the Internet may NOT be secure. Catawba Valley Medical Center makes no warranty, express or implied, regarding the security of any information to be submitted to it through this web site. There is a risk that confidential information submitted by you to Catawba Valley Medical Center through this web site, including a completed Pre-Registration Form, may be intercepted illegally by a third party. If you elect to electronically submit a completed Pre-Registration Form, or any other information, to Catawba Valley Medical Center through this web site, you agree that you do so at your own choice and risk, and that you assume all responsibility for any liability arising from such electronic submission or from any errors or omissions in the data you provide. You agree to release and hold Catawba Valley Medical Center harmless from any and all liability or cause of action arising from the interception, access or use by a third party of any information submitted electronically by you through this web site or from any errors or omissions in the data you provide. Additionally, the provision of any information to Catawba Valley Medical Center by you through this web site, including a completed Pre-Registration Form, does not create or constitute any relationship between you and Catawba Valley Medical Center (its directors, officers, employees, shareholders, agents or representatives), or any of the physicians who are members of the Medical Staff, to which any privilege may attach. |