PhilHealth Annex I.1A: Checklist of Essential Health Services Using CAPD - Adult
Fill PhilHealth Annex I.1A: Checklist of Essential Health Services Using CAPD - Adult online and download the official form as a PDF, ready to print. Every input is mapped to its printed box, so IDs, dates and amounts land digit by digit in the right cells, and a value the form cannot hold is refused with the reason instead of being printed wrong.
What you will need: Case No, DATE OF CONSULTATION (mm/dd/yyyy), Last Name, First Name, Suffix, Middle Name, PhilHealth ID Number, Same as patient, Name of the Attending Nephrologist, 2.5% or 2.3 %, 4.25%, Number of exchanges covered by PhilHealth per day (place a, Calcium content, Transfer set given (2 per calendar year, every six months), Topical antiseptic spray.
Free to try: 5 forms a day without an account; a free account gets 14 days of clean PDFs, then 25 a month. Not affiliated with BIR, SSS, PhilHealth, Pag-IBIG or any government agency.