Please submit your online pre-registration at least 48 hours in advance of check-in to ensure timely processing.
If you choose to utilize our Pre-registration Form, understand that you do so at your own choice
and risk. Any information you submit via the Pre-registration Form is
confidential and is only shared with third parties as outlined in our Privacy
Pledge. For more information, please read our Patient Privacy Notice.
If you elect to electronically submit a completed Pre-registration Form or
any other information to Surgery Center of Cullman through this web site, you
agree that you do so at your own choice and risk, and that you assume all
responsibility for any liability arising from such electronic submission and
from any errors or omissions in the data you provide. You agree to release and
hold Surgery Center of Cullman and its affiliates (including its directors,
officers, employees, shareholders, agents and representatives) harmless from any
and all liability or cause of action arising from the interception, access or
use by a third party of any information submitted electronically by you through
this web site and from any errors or omissions in the data you provide.
Additionally, the provision of any information to Surgery Center of Cullman by you
through this web site, including a completed Pre-registration Form, does not
create or constitute any relationship between you and Surgery Center of Cullman,
its affiliates, or any of the physicians on its staff, to which any privilege