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

Patient Rights, Responsibilities & Advance Directives
Authorization to Release Medical Information Form
Autorización para difundir información médica
Care of Personal Belongings
Advance Directive
Instrucciones Previas para Cuidados de Salud
Notice of Privacy Practices
Notificación de Normas de Confidencialidad