Baylor Scott & White Medical Center – White Rock
Please fill out the form below, and we’ll confirm with you when received if you have included a valid email address. At that time, we’ll also let you know if we need any additional information.
If this is an emergency, please dial 911 or go to the nearest emergency room. This form is not for ER registration.
Fields marked with an asterisk(*) are required.
Note: Selecting the arrows in the title areas will expand and hide the pre-registration questions for your convenience.
If you have questions about the pre-registration process, please contact us at 888.773.7342.
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