Using our Online Pre-Admission Form

Please enter your information on the following pages. The fields with an asterisk are required and must be completed in order for you to be able to submit the form. If these fields are left blank, your registration won't be sent.

Your Privacy

Mills-Peninsula assures protection of your personal health information. Our website securely transfers your information to our data systems. You may read about our Privacy Policy and HIPAA (Health Insurance Portability and Accountability Act of 1996) requirements (Opens new window) here. You can verify Mills-Peninsula is collecting your information over a secure site by clicking on the padlock icon located near your browser's address bar and viewing our certification form.

Financial Assistance

Mills-Peninsula provides financial assistance for low-income people who do not have health insurance. For more information contact the Business Services Department at (650) 652-3000.