PhilHealth Annex “ A – Hearing Impairment ”
Fill PhilHealth Annex “ A – Hearing Impairment ” 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, HEALTH CARE INSTITUTION (HCI), ADDRESS OF HCI, PATIENT (Last name, First name, Middle name, Suffix), PHILHEALTH ID NUMBER OF PATIENT, PHILHEALTH ID NUMBER OF MEMBER, Fulfilled selections criteria, If no, specify reason/s and encode, The child’s age is 0 to 17 years and 364 days old, The child must have undergone professional assessment and was diagnosed, Presence of delay on auditory milestones and/or communication issues, Sensorineural hearing loss presenting with either moderate or severe to.
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.