PhilHealth Annex “ J – Visual Disabilities ”
Fill PhilHealth Annex “ J – Visual Disabilities ” 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, PATIENT (Last name, First name, Middle name, Suffix), BIRTHDAY (mm/dd/yyyy), ADDRESS, CONTACT NUMBER, This certifies that patient, Training on the use of the device, Training on activities of daily living, Visual skills training, Environmental adaptation, Others, specify, Remarks (if any).
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.