Several Intermountain surgical and endoscopy services provide Online Health History forms for surgery or endoscopy procedures, which can be completed and submitted online in a secure electronic format.
Remember-- some hospitals provide surgical and procedure services at more than one location. To be sure your history form is sent to the right facility, please confirm exactly where your surgery or procedure will be performed, by contacting your surgeon's or doctor's office.
Salt Lake Area Surgical Services Online Pre-Registration Forms
To receive access to online history forms--patients MUST pre-register first.
Patients can pre-register by either filling out a pre-registration form online (see links below) OR by calling the pre-registration center at (801) 314-4395 or 1-888-269-8674; Mon-Fri, 8am - 7pm and Sat, 8am - 4pm.
A Patient Access Service Representative will send you an email with the link to fill out the history forms online.
Salt Lake Area Endoscopy Online Pre-Registration Forms
Other Surgery Online Health History Forms
Pre-Registration is currently by phone only for the following facilities.. Direct links to these facility's online histories are provided below.
Other Endoscopy Online Health History Forms
For additional information and contact numbers for Intermountain's surgical and endoscopy services: