A properly accomplished PMRF shall be accompanied by a valid proof of identity for first time registrants, and supporting documents to establish relationship between member and dependent/s for updating or request for amendment.

Claim Form 1: Member and Patient Information (Revised September 2018) Claim Form 2: Provider Information (Revised September 2018) Claim Form 3: Patient's Clinical Record

Fill out two (2) copies of the PhilHealth Member Registration Form (PMRF) Submit PMRF to the HR Department of employer; Await Member Data Record and PhilHealth ID card from employer; for newly hired employees with PIN. Report your PIN to your employer for them to indicate the same in their ER2; premium requirements

The Revised PhilHealth Member Registration Form (PMRF) To All Employers and Members; Please be informed that the PhilHealth Circular No. 2020-0001 on "The Revised PhilHealth Member Registration Form (PMRF)", is now posted in our website.

A properly accomplished PMRF shall be accompanied by a valid proof of identity for first time registrants, and supporting documents to establish relationship between member and dependent/s for updating or request for amendment.

Fill out (2) copies of the PhilHealth Member Registration Form (PMRF) Submit PMRF to the LHIO or PhilHealth Express; Await Member Data Record (MDR) and PhilHealth ID Card; Pay the necessary premium contribution using your PhilHealth ID number; Schedule of payment:

National Health Insurance-Program shall now use the attached PhilHealth Member Registration Form (PMRF). This PMRF is consistent with the new membership categories as stated in Section 5 of the Implementing Rules and Regulations (IRR) of the National Health Insurance Act of 2013.

1. Download PhilHealth Member Registration Form or (PMRF) 2. Tick FOR UPDATING on the upper right-hand corner of the PMRF. 3. Fill out PMRF as appropriate. 4. Submit properly filled out PMRF to the nearest PhilHealth Office. 5. Await printout of updated Member Data Record

J. Phi!Health Member Registration Form (PMRF) - refers to the form used by the Corporation for the registration of new members or updating/ amendment of personal information of existing Phi!Health members.

PHILHEALTH MEMBER REGISTRATION FORM FOR FOREIGN NATIONAL MEMBER’S PROFILE PhilHealth Number : _____ ACR I-card Number : _____ PRA SRRV Number : _____ (For PRA-registered Foreign Retiree)