Peninsula Regional Medical Center - Part of Peninusula Regional Health System
Patient Forms and Information


Peninsula Regional welcomes you to our Medical Center.  We want your inpatient stay with us to be as stress free as possible and your experience to exceed your expectations.  Our goal is your complete satisfaction from the moment you arrive until your discharge home.

Below you will find valuable information, forms and instructions.  We ask that you review the information here prior to your inpatient visit, print it, fill it out and bring this information with you when you register.

If you have any questions, please call us at 410-546-6400 and ask to speak with a representative of our Patient Access Services department.

 Forms and Information

Advance Directives
Authorization to Release Medical Information Form
Care of Personal Belongings
Help Us Know Your Medications Card
(English) (Spanish)


Print    
 Getting You There  Getting You There
 Directions  Directions
 Executive Staff Contacts  Executive Staff Contacts
 Food and Nutrition  Food and Nutrition
 Frequently Called Numbers  Frequently Called Numbers
 Health Information Management  Health Information Management
 Lodging  Lodging
 Modified Visitor Policy  Modified Visitor Policy
 Parking  Parking
 Patient Care Management  Patient Care Management
 Patient Financial Services  Patient Financial Services
 Patient Rights and Responsibilities  Patient Rights and Responsibilities
 Patient Satisfaction/Service Excellence  Patient Satisfaction/Service Excellence
 Patient Forms and Information  Patient Forms and Information
Strategic Plan 2009-2014
Find A Physician
MyPenCare
Foundation Ways to Give
Classes and Events
Bill Pay
Parking and Maps
Peninsula Regional Medical Group
Patient Greeting Card
CaringBridge
Clinical Partnerships
Contact Us


Notice of Privacy Practices Disclaimer About Us Site Map