HEALTHCARE PATIENT INTAKE & REGISTRATION WORKFLOW CHECKLIST 2026

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--- PRE-ARRIVAL & APPOINTMENT VERIFICATION ---
[ ] Appointment Date
[ ] Scheduled Appointment Time
[ ] Patient Full Name
[ ] Appointment Type (New Patient, Follow-up, Urgent/Walk-in, Telehealth)
[ ] Pre-Arrival Tasks Completed (Insurance Verified, Referral Received, Pre-Registration Form Completed)
[ ] Scan of Referral Document

--- PATIENT IDENTIFICATION & DEMOGRAPHIC COLLECTION ---
[ ] Legal First and Last Name
[ ] Patient Date of Birth
[ ] Primary Phone Number
[ ] Residential Address
[ ] Gender Identity (Male, Female, Non-binary, Prefer not to say)
[ ] Government Issued ID Scan
[ ] Patient/Guardian Verification of Accuracy

--- INSURANCE VERIFICATION & AUTHORIZATION ---
[ ] Primary Insurance Carrier Name
[ ] Insurance Member ID Number
[ ] Insurance Policy Effective Date
[ ] Insurance Type (PPO, HMO, Medicare, Medicaid, Commercial/Private, Self-Pay)
[ ] Required Authorizations Verified (Prior Authorization Obtained, Referral Validated, Network Status Confirmed)
[ ] Insurance Card Scan
[ ] Registrar Verification Signature

--- CONSENT & LEGAL DOCUMENTATION ---
[ ] Date of Consent Signing
[ ] Documents Reviewed (HIPAA Privacy Notice, Consent for Treatment, Financial Responsibility Agreement, Release of Information (ROI), Telehealth Consent Form)
[ ] Scanned Signed Documents
[ ] Registrar Verification Signature
[ ] Patient Identity Verified via ID (Yes, No)

--- MEDICAL HISTORY & CLINICAL SCREENING ---
[ ] Known Allergies (Penicillin, Latex, Sulfa Drugs, Peanuts, None)
[ ] Current Medications & Dosages
[ ] Blood Type (A+, A-, B+, B-, AB+, AB-, O+, O-, Unknown)
[ ] Date of Last Major Surgery
[ ] Current Body Weight (kg)
[ ] Patient/Guardian Attestation of Accuracy

--- PAYMENT COLLECTION & FINANCIAL RESPONSIBILITY ---
[ ] Co-pay Amount Collected
[ ] Payment Method (Credit/Debit Card, , Check, HSA/FSA Card)
[ ] Outstanding Balance Notes
[ ] Financial Responsibility Forms Signed (Financial Policy Agreement, Assignment of Benefits, Deposit Receipt)
[ ] Registrar Acknowledgment

--- IDENTITY VERIFICATION & PHOTO DOCUMENTATION ---
[ ] Government ID Type
[ ] ID Document Number
[ ] ID Expiration Date
[ ] Scan/Photo of Government ID
[ ] Patient Facial Photo Capture
[ ] Verification Checklist Completed (Name matches EHR record, Photo matches patient face, ID is unexpired, Address verified)
[ ] Registrar Verification Signature

--- ELECTRONIC HEALTH RECORD (EHR) INTEGRATION ---
[ ] Data Verification Checklist (Patient demographics matched with ID, , All mandatory clinical fields completed, All signed consents uploaded)
[ ] Scanned Identity Document
[ ] Scanned Insurance Card
[ ] Last Record Audit Date
[ ] Registration Clerk Notes
[ ] Registrar Verification Signature

--- PATIENT CHECK-IN COMPLETION & ROOMING HANDOVER ---
[ ] Check-in Status (Completed, Pending Additional Info, Escalated to Manager)
[ ] Assigned Exam Room Number
[ ] Handover Checklist Items (Patient vitals updated in EHR, All consent forms signed, Insurance verified, Co-pay collected)
[ ] Handover Time
[ ] Staff Handover Signature
[ ] Clinical Notes or Special Instructions

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