PhilHealth Annex “J – Mobility Impairment”
Fill PhilHealth Annex “J – Mobility 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, PATIENT (Last name, First name, Middle name, Suffix), BIRTHDAY (mm/dd/yyyy), ADDRESS, CONTACT NUMBER, This certifies that patient, the training on the safe and functional use of the device, Remarks (if any), Printed name and signature, Certified by, PhilHealth Accreditation No, Birthday (mm/dd/yyyy).
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.