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Extra Check-In Window

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Opens a second admission window for simultaneous dual check-ins. $190-200 Animal Coins (reduced from $210 in the 6/19 patch).

Overview

Extra Check-In Window unlocks a second admission slot in the lobby per Fandom, so two patients can be processed in parallel during Ambulance Event surges and high-traffic shifts. The price was reduced from $210 to $190-200 in the 2026-06-19 patch — making it more accessible than at launch. Persistent across the run.

This upgrade synergises strongly with the Secretary class — Secretary restores sanity per successful check-in, so doubling the check-in rate also doubles the per-shift sanity income from that passive. The combination is the strongest documented lobby-focused configuration in the game.

The trade-off: opening the second window also exposes a new spawn location for Head Banger, the enemy that specifically targets the second check-in slot (see /wiki/enemies/head-banger). Pre-upgrade shifts can't have Head Banger encounters at all because the second window doesn't exist; post-upgrade shifts will see Head Banger appear when the encounter rolls.

Video Guide

Upgrade demo video coming soon.

What This Upgrade Does

  • Permanently unlocks a second admission window in the lobby
  • Two patients can be checked in concurrently rather than sequentially
  • Doubles potential intake throughput during high-traffic shifts
  • Persistent across shifts in the same run
  • Opens a new spawn location for Head Banger enemy

Cost vs Value Analysis

Pros

  • ✓ Doubles potential intake throughput during Ambulance Event surges (Shift 4+)
  • ✓ Multiplies Secretary class sanity income (per-check-in passive doubles)
  • ✓ Persistent across shifts — buy once, benefit forever in the same run
  • ✓ Price reduced from $210 to $190-200 in 6/19 patch — more accessible than at launch

Cons

  • ✗ Opens Head Banger spawn location (didn't exist pre-upgrade)
  • ✗ $190-200 is mid-tier pricing — competes with Faster Computers and DNA Analysis
  • ✗ Minimal value on treatment-focused playstyles where intake isn't the bottleneck
  • ✗ Requires Coffee on hand to handle Head Banger encounters post-upgrade

At a Glance

At a Glance

Cost
$190-200 Animal Coins (reduced from $210 in 6/19 patch)
Stackable
No (single purchase)
Category
Upgrade

When to Buy This Upgrade

Buy on Shift 3 or 4 if you're playing Secretary class or any lobby-focused playstyle. The sanity-income doubling pays back the $190-200 cost within a few shifts of normal intake volume.

Buy before the first Ambulance Event (Shift 4) if Animal Coin income permits. The 6-patient surge is the highest-throughput intake scenario in the game; the dual-window upgrade significantly improves the surge response.

Delay or skip if you're running treatment-focused classes (Doctor, Surgeon, Surgeon-team) where intake isn't the bottleneck. Those classes get more value from Patient Recovery, Faster Computers, or DNA Analysis upgrades.

Warning planning: post-upgrade, Head Banger encounters become possible. Stock at least one Coffee per shift after buying this upgrade — the Coffee bribe is the cheapest Head Banger counter (see /wiki/enemies/head-banger for the workflow). Pre-sipping the Coffee twice before handing it over keeps the encounter cost at just 5 sanity.

For maximum Secretary configuration: Extra Check-In Window ($190-200) + Faster Check-In Premium ($250) + Visitors check in faster ($20) + Secretary class itself ($120). Total investment $580-590; produces the strongest documented front-desk sanity income.

Patch History

Per Fandom, the 2026-06-19 patch reduced the price from $210 to $190-200. No documented changes to the upgrade's mechanical effect (second window unlock) or to the Head Banger spawn-location side effect.

Frequently Asked Questions

How much does Extra Check-In Window cost?
$190-200 Animal Coins per Fandom — reduced from $210 in the 2026-06-19 patch.
What does Extra Check-In Window unlock?
A second admission slot in the lobby. Two patients can be checked in concurrently rather than sequentially. Doubles potential intake throughput on high-traffic shifts.
Does this upgrade open new enemy spawns?
Yes — Head Banger specifically targets the second check-in window. Pre-upgrade, Head Banger encounters cannot occur. Post-upgrade, stock Coffee to handle Head Banger when it appears.
Which class benefits most from Extra Check-In Window?
Secretary class. The +1 sanity per check-in passive scales linearly — doubling the check-in rate doubles the per-shift sanity income from the passive.
Was the price changed in a patch?
Yes — per Fandom, the 2026-06-19 patch reduced the price from $210 to $190-200 (the exact value within that range isn't fixed).
Should I buy this before the Shift 4 Ambulance Event?
Yes if Animal Coin income permits. The 6-patient surge is the highest-throughput intake scenario; the dual-window upgrade significantly improves the surge response.
Can I close the second window after buying the upgrade?
Not documented in Fandom or AH sources. Treat the upgrade as one-way — the second window persists for the rest of the run, including the Head Banger spawn risk.