Surgery Center

Jackson-Madison County General Hospital is committed to protecting your privacy and personal medical information. All of our online forms use 256-bit SSL encryption to protect your online submissions. While we take all precautions to secure our forms, there are other factors that could compromise the transmission of the data you submit. If you choose to electronically submit your data using the Pre-Admission Registration form, you agree to do so at your own risk and you assume all responsibility for any liability as a result of this online submission and from any omissions or errors in the information you provide. You agree to release and hold harmless Jackson-Madison County General Hospital and its affiliates including but not limited to directors, officers, associates, shareholders, agents and representatives from any and all liability or cause of action arising from the interception, access, or use by a third party of any data submitted across the internet via this website and from any omissions or errors in the information you provide. Furthermore, the provision of any information by you to Jackson-Madison County General Hospital via this website does not establish or make official any relationship between you and Jackson-Madison County General Hospital, its affiliates, or any of the physicians on its staff, to which any privilege may be connected.