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Form 2. Medical Examination Application Form
This form is intended for applicants who needs to undergo a medical examination for overseas employment.
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* Indicates required question
Email
*
Your email
1. Full Name (Last, First Middle)
*
Answer in ALL CAPS. EX: DELA CRUZ, JUAN MIGUEL
Your answer
2. Name of Employer
*
Anwser in ALL CAPS. EX: YUJU KAI SOCIAL WELFARE CORPORATION
Your answer
3. Name of Kumiai/Supervising Organization
*
Anwser in ALL CAPS. EX: J TRADING COOPERATIVE. If not applicable, write N/A.
Your answer
4. Visa Category
*
Choose the correct type. For new applicants, choose TITP i.
TITP i
TITP iii
SSW i
SSW ii
5. Purpose of Medical Examination
*
Choose the correct type. For new applicants, choose Pre-Qualification.
Pre-Qualification
Pre-Deployment
Other:
6. Current Address
*
Write in ALL CAPS. EX: 3F DRAGON BLDG., 124B V. LUNA EXT. SIKATUNA VILLAGE, QUEZON CITY
Your answer
7. Nearest Clinic (Option 1)
*
This list is from the D.O.H. LIST OF ACCREDITED MEDICAL FACILITIES FOR OVERSEAS WORKERS AND SEAFARERS as of August 15, 2022.
Choose
ILOCOS - DAGUPAN DOCTORS VILLAFLOR MEM. HOSP., INC. (MCARTHUR HI-WAY, MAYOMBO DISTRICT, DAGUPAN CITY)
ILOCOS - LA UNION MEDICAL DIAGNOSTIC CENTER AND HOSPITAL, INC. (ANCHETA ST. COR. BUCAENG ST., SAN FERNANDO CITY, LA UNION)
ILOCOS - LORMA MEDICAL CENTER INC. (CARLATAN, SAN FERNANDO CITY, LA UNION)
ILOCOS - UNIVERSAL ADVANCE MEDICAL DIAGNOSTICS LABORATORY, INC. (2.F the Pentagon Bldg., McArthut Highway, Nancayasan, Urdaneta City)
REGION IV-A - DANIEL MERCADO MEDICAL CENTER-INDUSTRIAL CLINIC & OCCUPATIONAL HEALTH UNIT (#1 PRES. LAUREL HIGHWAY, TANAUAN CITY, BATANGAS)
REGION IV-A - EMILIO AGUINALDO COLLEGE MEDICAL CENTER (BRGY SALITRAN 2, DASMARINAS CITY, CAVITE)
REGION IV-A - HMICARE, INC. (9178 GEN. EMILIO AGUINALDO HIGHWAY, SAMPALOC I, DASMARINAS CITY, CAVITE)
REGION IV-A - PIONEER CLINICAL LABORATORY AND MEDICAL CLINIC, INC. (PCLI, NO. 1 P. NOBLE ST., BATANGAS CITY)
REGION VI - DR. V. T. TALEON MEDICAL CLINIC (GF, YMCA BLDG., IZNART ST., ILOILO CITY)
REGION VI - HEALTHLINK (ILOILO), INC. (#12 MABINI ST., BRGY SAN AGUSTIN, ILOILO CITY)
REGION VI - HEALTH METRICS, INC. - ILOILO (2F MANFREDS INN, 22 GEN. LUNA ST., BRGY SAN AGUSTIN, ILOILO CITY)
REGION VI - ILOILO PDS & LABORATORY CENTER (#7 MABINI ST., LA PAZ, BRGY RAILWAY, ILOILO CITY)
REGION VI - JARANILLA MEDICAL CLINIC (JAVELLANA ST., LAPAS, ILOILO CITY)
REGION VI - MEDICUS MEDICAL CLINIC (GF ROMEO GO BLDG., HUERVANA ST., LA PAZ, ILOILO CITY)
REGION VI - MEDISENCE LABORATORY CENTER, INC. (DOOR #3 AU & SONS BLDG., BURGOS ST., BACOLOD CITY)
REGION VI - MEDISENSE LABORATORY CENTER, INC. (DELGADO ST., BRGY MALIPAYON, ILOILO CITY)
REGION VI - Q DIAGNOSTIC CENTER, INC. (COR. LOCSIN-BURGOS STS., BRGY 11, BACOLOD CITY)
REGION VI - STATLAB, INC. (#30 QUEZON, FANCOM MEDICAL PLAZA, BRGY SAMPAGUITA, ILOILO CITY)
REGION VI - SUPERCARE MEDICAL SERVICES, INC. (3F 22 MANFRED'S PLACE, GEN. LUNA ST., ILOILO CITY)
REGION VI - TRANSNATIONAL MEDICAL AND DIAG. CENTER, INC. (E. LOPEZ ST., JARO, ILOILO CITY)
REGION VI - WATANAK DIAGNOSTIC CENTER (DOOR 6, 7, 8 PACE BLDG., 2ND LACSON ST., BRGY 7, BACOLOD CITY)
REGION VI - YGEIA MEDICAL CENTER, INC. (PASEO VERDE, LACSON DRIVE, BACOLODY CITY)
REGION VII - CEBU SAGRADA CORAZON HEALTH SERVICES, INC. (RM 304 & 310 CITY SAVINGS FINANCIAL PLAZA CONDOMINIUM, OSMENA BLVD., CEBU CITY)
REGION VII - GILLAMAC DIAGNOSIS AND MEDICAL LABORATORIES, INC. (169 SANCIANGKO ST., CEBU CITY)
REGION VII - JS MEDICAL AND DIAGNOSTIC CENTER (322 MACROVILLE CARDINAL ROSALES AVE., GORORGO AVE., CEBU CITY)
REGION VII - MEDISENSE LABORATORY, INC. ( NO LONGER AVAILABLE)
REGION VII - MY HEALTH CLINIC (3F ROBINSONS CYBERGATE MALL, FUENTE OSMENA, CEBU CITY)
REGION VII - PHYSICIAN'S DIAG. SERVICES CENTER, INC. (104 F. RAMOS COR. JUNQUERA STREETS, CEBU CITY)
REGION VII - ST. PETER-PAUL MEDICAL CLINIC, INC. (458 COLON ST., CEBU CITY)
REGION VII - SUPERCARE MEDICAL SERVICES, INC. (2F PBCOM BLDG., GEN MAXILLOM AVE., CEBU CITY)
REGION VII - UNIVERSITY OF CEBU MEDICAL CENTER, INC. (OUANO AVE., NORTH RECLAMATION AREA, SUBANGDAKU, MANDAUE CITY, CEBU)
REGION VII - ZAFF JAY MEDILINES, INC. (ANNEX 1, CENTURY PLAZA COMMERCIAL COMPLEX, JUANA OSMENA ST., CEBU CITY)
REGION IX - MEDISENSE LABORATORY, INC. (2F JBL BLDG., CANELAR ST., ZAMBOANGA CITY)
REGION X - MEDISENSE LABORATORY CENTER, INC. (3F JARDINIANO BLDG., SAN AGUSTINE ST, CAGAYAN DE ORO CITY)
REGION X - PDS PEME SYSTEM INTERNATIONAL (BRGY 5, BURGOS ST. COR. T. CHAVEZ ST., CAGAYAN DE ORO CITY)
REGION XI - BMCDC HEALTH CARE, INC. (JJLL BLDG., 1, STO. NINO VILLAGE, MCARTHUR HIGHWAY, MATINA, DAVAO CITY)
REGION XI - HYATT DIAGNOSTIC SYSTEM, INC. (2F JALTAN BLDG, C.M. RECTO, DAVAO CITY)
REGION XI - MEDISENSE LABORATORY CENTER, INC. (2F DAKODAO & SONS BLDG., #3 SAN PEDRO ST., DAVAO CITY)
REGION XI - PHYSICIANS' DIAGNOSTIC AND HEALTH SERVICE CENTER, INC. - DAVAO (49 JOSE PALMA GIL ST., BRGY 4A, DIST. 1, DAVAO CITY)
REGION XI - PREMIER DIAGNOSTIC AND HEALTH SERVICE CENTER, INC. (2F SAN BLDG., J.P. LAUREL AVE. COR CABAGUIO ST., DAVAO CITY)
REGION XI - RPMED ADVANCED DIAGNOSTIC & OUTPATIENT CENTER (36 QUIMPO BLVD., ECOLAND PHASE 1, DAVAO CITY)
REGION XI - SOUTHERN PHILIPPINES MEDICAL CENTER (J.P. LAUREL AVE., BAJADA, DAVAO CITY)
REGION XI - ST. PETER-PAUL MEDICAL CLINIC, INC. (208 LEE BUSINESS CENTER COR. JUAN LUNA AND JUAN DELA CRUZ STS., DAVAO CITY)
REGION XI - YLO DIAGNOSTIC MEDICAL CLINIC, INC. (2F DIMACALI BLDG., LEGASPI ST., DAVAO CITY)
REGION XII - SOCSARGEN COUNTY HOSPITAL (L. ARRADAZA ST., BULA-LAGAO RD., LAGAO, GEN. SANTOS CITY)
CAR - BAGUIO DOCTORS MEDICAL LABORATORIES (RM 214 G.P SHOPPING ARCADE, UPPER MABINI ST., BAGUIO CITY)
CAR - BENGUETCORP LABORATORIES, INC. (A4 & B01 BAGUIO CYBERZONE, HARRISON ROAD, BAGUIO CITY)
NCR - ST PATRICK'S HEALTH CARE SYSTEM INC. (566 SHAW BLVD., MANDALUYONG CITY)
NOT ON THIS LIST
8. Nearest Clinic (Option 2)
*
This list is from the D.O.H. LIST OF ACCREDITED MEDICAL FACILITIES FOR OVERSEAS WORKERS AND SEAFARERS as of August 15, 2022.
Choose
ILOCOS - DAGUPAN DOCTORS VILLAFLOR MEM. HOSP., INC. (MCARTHUR HI-WAY, MAYOMBO DISTRICT, DAGUPAN CITY)
ILOCOS - LA UNION MEDICAL DIAGNOSTIC CENTER AND HOSPITAL, INC. (ANCHETA ST. COR. BUCAENG ST., SAN FERNANDO CITY, LA UNION)
ILOCOS - LORMA MEDICAL CENTER INC. (CARLATAN, SAN FERNANDO CITY, LA UNION)
ILOCOS - UNIVERSAL ADVANCE MEDICAL DIAGNOSTICS LABORATORY, INC. (2F PENTAGON BLDG., MCARTHUR HIGHWAY, NANCAYASAN, URDANETA CITY)
REGION IV-A - DANIEL MERCADO MEDICAL CENTER-INDUSTRIAL CLINIC & OCCUPATIONAL HEALTH UNIT (#1 PRES. LAUREL HIGHWAY, TANAUAN CITY, BATANGAS)
REGION IV-A - EMILIO AGUINALDO COLLEGE MEDICAL CENTER (BRGY SALITRAN 2, DASMARINAS CITY, CAVITE)
REGION IV-A - HMICARE, INC. (9178 GEN. EMILIO AGUINALDO HIGHWAY, SAMPALOC I, DASMARINAS CITY, CAVITE)
REGION IV-A - PIONEER CLINICAL LABORATORY AND MEDICAL CLINIC, INC. (PCLI, NO. 1 P. NOBLE ST., BATANGAS CITY)
REGION VI - DR. V. T. TALEON MEDICAL CLINIC (GF, YMCA BLDG., IZNART ST., ILOILO CITY)
REGION VI - HEALTHLINK (ILOILO), INC. (#12 MABINI ST., BRGY SAN AGUSTIN, ILOILO CITY)
REGION VI - HEALTH METRICS, INC. - ILOILO (2F MANFREDS INN, 22 GEN. LUNA ST., BRGY SAN AGUSTIN, ILOILO CITY)
REGION VI - ILOILO PDS & LABORATORY CENTER (#7 MABINI ST., LA PAZ, BRGY RAILWAY, ILOILO CITY)
REGION VI - JARANILLA MEDICAL CLINIC (JAVELLANA ST., LAPAS, ILOILO CITY)
REGION VI - MEDICUS MEDICAL CLINIC (GF ROMEO GO BLDG., HUERVANA ST., LA PAZ, ILOILO CITY)
REGION VI - MEDISENCE LABORATORY CENTER, INC. (DOOR #3 AU & SONS BLDG., BURGOS ST., BACOLOD CITY)
REGION VI - MEDISENSE LABORATORY CENTER, INC. (DELGADO ST., BRGY MALIPAYON, ILOILO CITY)
REGION VI - Q DIAGNOSTIC CENTER, INC. (COR. LOCSIN-BURGOS STS., BRGY 11, BACOLOD CITY)
REGION VI - STATLAB, INC. (#30 QUEZON, FANCOM MEDICAL PLAZA, BRGY SAMPAGUITA, ILOILO CITY)
REGION VI - SUPERCARE MEDICAL SERVICES, INC. (3F 22 MANFRED'S PLACE, GEN. LUNA ST., ILOILO CITY)
REGION VI - TRANSNATIONAL MEDICAL AND DIAG. CENTER, INC. (E. LOPEZ ST., JARO, ILOILO CITY)
REGION VI - WATANAK DIAGNOSTIC CENTER (DOOR 6, 7, 8 PACE BLDG., 2ND LACSON ST., BRGY 7, BACOLOD CITY)
REGION VI - YGEIA MEDICAL CENTER, INC. (PASEO VERDE, LACSON DRIVE, BACOLODY CITY)
REGION VII - CEBU SAGRADA CORAZON HEALTH SERVICES, INC. (RM 304 & 310 CITY SAVINGS FINANCIAL PLAZA CONDOMINIUM, OSMENA BLVD., CEBU CITY)
REGION VII - GILLAMAC DIAGNOSIS AND MEDICAL LABORATORIES, INC. (169 SANCIANGKO ST., CEBU CITY)
REGION VII - JS MEDICAL AND DIAGNOSTIC CENTER (322 MACROVILLE CARDINAL ROSALES AVE., GORORGO AVE., CEBU CITY)
REGION VII - MEDISENSE LABORATORY, INC. ( NO LONGER AVAILABLE)
REGION VII - MY HEALTH CLINIC (3F ROBINSONS CYBERGATE MALL, FUENTE OSMENA, CEBU CITY)
REGION VII - PHYSICIAN'S DIAG. SERVICES CENTER, INC. (104 F. RAMOS COR. JUNQUERA STREETS, CEBU CITY)
REGION VII - ST. PETER-PAUL MEDICAL CLINIC, INC. (458 COLON ST., CEBU CITY)
REGION VII - SUPERCARE MEDICAL SERVICES, INC. (2F PBCOM BLDG., GEN MAXILLOM AVE., CEBU CITY)
REGION VII - UNIVERSITY OF CEBU MEDICAL CENTER, INC. (OUANO AVE., NORTH RECLAMATION AREA, SUBANGDAKU, MANDAUE CITY, CEBU)
REGION VII - ZAFF JAY MEDILINES, INC. (ANNEX 1, CENTURY PLAZA COMMERCIAL COMPLEX, JUANA OSMENA ST., CEBU CITY)
REGION IX - MEDISENSE LABORATORY, INC. (2F JBL BLDG., CANELAR ST., ZAMBOANGA CITY)
REGION X - MEDISENSE LABORATORY CENTER, INC. (3F JARDINIANO BLDG., SAN AGUSTINE ST, CAGAYAN DE ORO CITY)
REGION X - PDS PEME SYSTEM INTERNATIONAL (BRGY 5, BURGOS ST. COR. T. CHAVEZ ST., CAGAYAN DE ORO CITY)
REGION XI - BMCDC HEALTH CARE, INC. (JJLL BLDG., 1, STO. NINO VILLAGE, MCARTHUR HIGHWAY, MATINA, DAVAO CITY)
REGION XI - HYATT DIAGNOSTIC SYSTEM, INC. (2F JALTAN BLDG, C.M. RECTO, DAVAO CITY)
REGION XI - MEDISENSE LABORATORY CENTER, INC. (2F DAKODAO & SONS BLDG., #3 SAN PEDRO ST., DAVAO CITY)
REGION XI - PHYSICIANS' DIAGNOSTIC AND HEALTH SERVICE CENTER, INC. - DAVAO (49 JOSE PALMA GIL ST., BRGY 4A, DIST. 1, DAVAO CITY)
REGION XI - PREMIER DIAGNOSTIC AND HEALTH SERVICE CENTER, INC. (2F SAN BLDG., J.P. LAUREL AVE. COR CABAGUIO ST., DAVAO CITY)
REGION XI - RPMED ADVANCED DIAGNOSTIC & OUTPATIENT CENTER (36 QUIMPO BLVD., ECOLAND PHASE 1, DAVAO CITY)
REGION XI - SOUTHERN PHILIPPINES MEDICAL CENTER (J.P. LAUREL AVE., BAJADA, DAVAO CITY)
REGION XI - ST. PETER-PAUL MEDICAL CLINIC, INC. (208 LEE BUSINESS CENTER COR. JUAN LUNA AND JUAN DELA CRUZ STS., DAVAO CITY)
REGION XI - YLO DIAGNOSTIC MEDICAL CLINIC, INC. (2F DIMACALI BLDG., LEGASPI ST., DAVAO CITY)
REGION XII - SOCSARGEN COUNTY HOSPITAL (L. ARRADAZA ST., BULA-LAGAO RD., LAGAO, GEN. SANTOS CITY)
CAR - BAGUIO DOCTORS MEDICAL LABORATORIES (RM 214 G.P SHOPPING ARCADE, UPPER MABINI ST., BAGUIO CITY)
CAR - BENGUETCORP LABORATORIES, INC. (A4 & B01 BAGUIO CYBERZONE, HARRISON ROAD, BAGUIO CITY)
NOT ON THIS LIST
NCR - ST PATRICK'S HEALTH CARE SYSTEM INC. (566 SHAW BLVD., MANDALUYONG CITY)
9. Nearest Clinic (Option 3)
*
This list is from the D.O.H. LIST OF ACCREDITED MEDICAL FACILITIES FOR OVERSEAS WORKERS AND SEAFARERS as of August 15, 2022.
Choose
ILOCOS - DAGUPAN DOCTORS VILLAFLOR MEM. HOSP., INC. (MCARTHUR HI-WAY, MAYOMBO DISTRICT, DAGUPAN CITY)
ILOCOS - LA UNION MEDICAL DIAGNOSTIC CENTER AND HOSPITAL, INC. (ANCHETA ST. COR. BUCAENG ST., SAN FERNANDO CITY, LA UNION)
ILOCOS - LORMA MEDICAL CENTER INC. (CARLATAN, SAN FERNANDO CITY, LA UNION)
ILOCOS - UNIVERSAL ADVANCE MEDICAL DIAGNOSTICS LABORATORY, INC. (2F PENTAGON BLDG., MCARTHUR HIGHWAY, NANCAYASAN, URDANETA CITY)
REGION IV-A - DANIEL MERCADO MEDICAL CENTER-INDUSTRIAL CLINIC & OCCUPATIONAL HEALTH UNIT (#1 PRES. LAUREL HIGHWAY, TANAUAN CITY, BATANGAS)
REGION IV-A - EMILIO AGUINALDO COLLEGE MEDICAL CENTER (BRGY SALITRAN 2, DASMARINAS CITY, CAVITE)
REGION IV-A - HMICARE, INC. (9178 GEN. EMILIO AGUINALDO HIGHWAY, SAMPALOC I, DASMARINAS CITY, CAVITE)
REGION IV-A - PIONEER CLINICAL LABORATORY AND MEDICAL CLINIC, INC. (PCLI, NO. 1 P. NOBLE ST., BATANGAS CITY)
REGION VI - DR. V. T. TALEON MEDICAL CLINIC (GF, YMCA BLDG., IZNART ST., ILOILO CITY)
REGION VI - HEALTHLINK (ILOILO), INC. (#12 MABINI ST., BRGY SAN AGUSTIN, ILOILO CITY)
REGION VI - HEALTH METRICS, INC. - ILOILO (2F MANFREDS INN, 22 GEN. LUNA ST., BRGY SAN AGUSTIN, ILOILO CITY)
REGION VI - ILOILO PDS & LABORATORY CENTER (#7 MABINI ST., LA PAZ, BRGY RAILWAY, ILOILO CITY)
REGION VI - JARANILLA MEDICAL CLINIC (JAVELLANA ST., LAPAS, ILOILO CITY)
REGION VI - MEDICUS MEDICAL CLINIC (GF ROMEO GO BLDG., HUERVANA ST., LA PAZ, ILOILO CITY)
REGION VI - MEDISENCE LABORATORY CENTER, INC. (DOOR #3 AU & SONS BLDG., BURGOS ST., BACOLOD CITY)
REGION VI - MEDISENSE LABORATORY CENTER, INC. (DELGADO ST., BRGY MALIPAYON, ILOILO CITY)
REGION VI - Q DIAGNOSTIC CENTER, INC. (COR. LOCSIN-BURGOS STS., BRGY 11, BACOLOD CITY)
REGION VI - STATLAB, INC. (#30 QUEZON, FANCOM MEDICAL PLAZA, BRGY SAMPAGUITA, ILOILO CITY)
REGION VI - SUPERCARE MEDICAL SERVICES, INC. (3F 22 MANFRED'S PLACE, GEN. LUNA ST., ILOILO CITY)
REGION VI - TRANSNATIONAL MEDICAL AND DIAG. CENTER, INC. (E. LOPEZ ST., JARO, ILOILO CITY)
REGION VI - WATANAK DIAGNOSTIC CENTER (DOOR 6, 7, 8 PACE BLDG., 2ND LACSON ST., BRGY 7, BACOLOD CITY)
REGION VI - YGEIA MEDICAL CENTER, INC. (PASEO VERDE, LACSON DRIVE, BACOLODY CITY)
REGION VII - CEBU SAGRADA CORAZON HEALTH SERVICES, INC. (RM 304 & 310 CITY SAVINGS FINANCIAL PLAZA CONDOMINIUM, OSMENA BLVD., CEBU CITY)
REGION VII - GILLAMAC DIAGNOSIS AND MEDICAL LABORATORIES, INC. (169 SANCIANGKO ST., CEBU CITY)
REGION VII - JS MEDICAL AND DIAGNOSTIC CENTER (322 MACROVILLE CARDINAL ROSALES AVE., GORORGO AVE., CEBU CITY)
REGION VII - MEDISENSE LABORATORY, INC. ( NO LONGER AVAILABLE)
REGION VII - MY HEALTH CLINIC (3F ROBINSONS CYBERGATE MALL, FUENTE OSMENA, CEBU CITY)
REGION VII - PHYSICIAN'S DIAG. SERVICES CENTER, INC. (104 F. RAMOS COR. JUNQUERA STREETS, CEBU CITY)
REGION VII - ST. PETER-PAUL MEDICAL CLINIC, INC. (458 COLON ST., CEBU CITY)
REGION VII - SUPERCARE MEDICAL SERVICES, INC. (2F PBCOM BLDG., GEN MAXILLOM AVE., CEBU CITY)
REGION VII - UNIVERSITY OF CEBU MEDICAL CENTER, INC. (OUANO AVE., NORTH RECLAMATION AREA, SUBANGDAKU, MANDAUE CITY, CEBU)
REGION VII - ZAFF JAY MEDILINES, INC. (ANNEX 1, CENTURY PLAZA COMMERCIAL COMPLEX, JUANA OSMENA ST., CEBU CITY)
REGION IX - MEDISENSE LABORATORY, INC. (2F JBL BLDG., CANELAR ST., ZAMBOANGA CITY)
REGION X - MEDISENSE LABORATORY CENTER, INC. (3F JARDINIANO BLDG., SAN AGUSTINE ST, CAGAYAN DE ORO CITY)
REGION X - PDS PEME SYSTEM INTERNATIONAL (BRGY 5, BURGOS ST. COR. T. CHAVEZ ST., CAGAYAN DE ORO CITY)
REGION XI - BMCDC HEALTH CARE, INC. (JJLL BLDG., 1, STO. NINO VILLAGE, MCARTHUR HIGHWAY, MATINA, DAVAO CITY)
REGION XI - HYATT DIAGNOSTIC SYSTEM, INC. (2F JALTAN BLDG, C.M. RECTO, DAVAO CITY)
REGION XI - MEDISENSE LABORATORY CENTER, INC. (2F DAKODAO & SONS BLDG., #3 SAN PEDRO ST., DAVAO CITY)
REGION XI - PHYSICIANS' DIAGNOSTIC AND HEALTH SERVICE CENTER, INC. - DAVAO (49 JOSE PALMA GIL ST., BRGY 4A, DIST. 1, DAVAO CITY)
REGION XI - PREMIER DIAGNOSTIC AND HEALTH SERVICE CENTER, INC. (2F SAN BLDG., J.P. LAUREL AVE. COR CABAGUIO ST., DAVAO CITY)
REGION XI - RPMED ADVANCED DIAGNOSTIC & OUTPATIENT CENTER (36 QUIMPO BLVD., ECOLAND PHASE 1, DAVAO CITY)
REGION XI - SOUTHERN PHILIPPINES MEDICAL CENTER (J.P. LAUREL AVE., BAJADA, DAVAO CITY)
REGION XI - ST. PETER-PAUL MEDICAL CLINIC, INC. (208 LEE BUSINESS CENTER COR. JUAN LUNA AND JUAN DELA CRUZ STS., DAVAO CITY)
REGION XI - YLO DIAGNOSTIC MEDICAL CLINIC, INC. (2F DIMACALI BLDG., LEGASPI ST., DAVAO CITY)
REGION XII - SOCSARGEN COUNTY HOSPITAL (L. ARRADAZA ST., BULA-LAGAO RD., LAGAO, GEN. SANTOS CITY)
CAR - BAGUIO DOCTORS MEDICAL LABORATORIES (RM 214 G.P SHOPPING ARCADE, UPPER MABINI ST., BAGUIO CITY)
CAR - BENGUETCORP LABORATORIES, INC. (A4 & B01 BAGUIO CYBERZONE, HARRISON ROAD, BAGUIO CITY)
NOT ON THIS LIST
NCR - ST PATRICK'S HEALTH CARE SYSTEM INC. (566 SHAW BLVD., MANDALUYONG CITY)
10. Preferred Date for Medical Examination
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11. Applicant's Contact Number
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