Maternity Registration

You may pre-register online via our secure form below. Please be assured that your personal information will be handled confidentially by our registration team.
For assistance with this form, please call: 908-788-6167.

For your arrival at the medical center, please bring:
  • Your insurance card(s)
  • Insurance referral, if it is required by your insurance carrier

If your insurance company requires a copayment or co-insurance for your hospital stay, we would appreciate your payment prior to your discharge.
Payments may be made by personal check, cash or credit card -- Visa, Master Card, Discover, American Express -- in the Admitting Department on the 1st floor.

Checks may be submitted to:
Hunterdon Medical Center
2100 Wescott Drive
Flemington, NJ 08822
ATTN: Pre-certification Department

For your convenience you may contact the pre-certification office at 908-788-5466 for the amount of payment due and/or any other question.

All fields with an asterisk (*) are required fields.

Patient Information

Read our Notice of Privacy Practice (NPP) for details about how we use and disclose Protected Health Information.





* Have you ever been a patient at Hunterdon Medical Center? Yes      No










* Would you like to be listed in the hospital directory so that if someone calls
or sends flowers we may confirm that you are in-house:   Yes     No    



  * Name of Practice or Physician/Obstetrician that
will be delivering your baby:












Yes     No    


Yes     No    











Is the Next of Kin's Address the same as the patient's address?

Subscriber to the insurance.
A subscriber is the person whose employment makes him or her eligible for membership in the plan.
Also a person who pays the premiums is eligible for membership.

Is the Primary Subscriber information the same as the

Is the Secondary Subscriber information the same as the

* Primary phone number is required.







Patient Employer