Register as a Patient

Patient Registration Notice

Please read the following carefully before completing your registration at Heritage Kidney & Medical Care:

Registration, Consultation, and Procedure Fees: All fees are non-refundable, even if referred to another specialist.
Referral to Specialists: See the General Duty Doctor first to avoid double consultation fees.
Electronic Medical Records & Prescriptions: All records are electronic. Prescriptions go directly to our Pharmacy; paper copies are not provided.
Laboratory Results: Lab results are posted electronically. Paper copies are available for a fee Monday to Friday, 8:00 AM – 9:00 PM.
Hospital Environment: Heritage Kidney & Medical Care is a no-smoking, alcohol-free, noise-free, and violence-free zone.
Payment of Fees: All services must be paid in full before being rendered.
Excuse Duty Notes: Papers can only be granted on the same day of the visit.

Please ensure you follow all guidelines to have a smooth registration experience.

Disclaimer: All information provided is securely stored and used only for hospital purposes.

Surname *

First Name *

Other Name

Sex *

Date of Birth *

Age *

Marital Status *

Religion

Occupation

State of Origin

Local Government

Tribe

Phone Number *

Email *

Home Address *

Office Address

Name of Next of Kin *

Relationship *

Address of Next of Kin

Phone Number (Next of Kin) *