Med-Key Application Step 1 of 5

Med-Key is a convenient, personalized card that you can present when you come to our hospital. Pre-programmed with all of your insurance and other registration information, your Med-Key card can simply be swiped when you come in – no need to fill out extra paperwork. Med-Key is a free service of the hospital and is also accepted by other Health Management Associates hospitals across the country.

To get your Med-Key card today, please complete the following application.

Denotes Required Field

Contact Information


Ex: John

Ex: A

Ex: Smith

Ex: Mr.


Home Address







Mailing Address

Same As Above






General Information


Ex: 1234-12-123

Ex: mm/dd/yyyy




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