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STILLWATER MEDICAL CENTER Esophagogastroduodenoscopy (EGD) ExamTASwafford INSTRUCTIONS Check in at the main registration desk at the front of the hospital. Time: Date: Day: EGD stands for Esophagogastroduodensoscopy.

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How to Fill Out Check-in Form:

01

Begin by writing your full name on the designated line. Make sure to use your legal name as it appears on your identification.

02

Provide your contact information including your phone number and email address. This will allow the establishment to reach out to you if needed.

03

Indicate your arrival date and time. This will help the staff at the establishment to track your arrival and ensure that your room is prepared.

04

Fill in your departure date and time to let the staff know when you plan on checking out. This helps them manage their reservations and allocate resources accordingly.

05

Specify the number of guests accompanying you. This is important for the establishment to determine the size of the room or accommodation required.

06

If you have any special requests or preferences, note them down in the designated section. This could include things like requiring a specific type of room, dietary restrictions, or any other specific needs you may have.

07

Finally, review the form for any errors or missing information before signing and dating it. This ensures that all the necessary details are captured accurately.

Who Needs the Check-in Form:

01

Any individual who is staying at a hotel, motel, or other accommodation establishments will typically need to fill out a check-in form. This includes both leisure and business travelers.

02

The check-in form is important for the establishment to gather essential information about their guests, such as contact details and duration of stay, to ensure a smooth and convenient experience.

03

The check-in form also helps the establishment keep accurate records of their guests for legal and security purposes. It provides a way to track the whereabouts of individuals within the facility and ensures the safety of all guests.

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