Binakayan Hospital Medical Center

Make an Appointment with Us!

    PATIENT APPOINTMENT REQUEST FORM

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    PATIENT CLASSIFICATION

    Patient Category

    Senior CitizenPWDBHMC Stockholder/DependentBHMC EmployeeNone of the above

    Do you have Alagang BHMC Suki Card?

    YesNo

    Do you already have a Physician from BHMC?

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    IMPORTANT NOTICE: For HMO/Insurance transactions, please ensure approval from BHMC's HMO Department at least one (1) business day prior to your scheduled appointment.

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    Service Selection:

    Please choose whether you are for consultation, procedure, or interested in our promos and packages.


    APPOINTMENT DETAILS


    PROCEDURE DETAILS


    LABORATORY SERVICES

    Clinical Chemistry

    Clinical Hematology

    Clinical Microscopy

    RADIOLOGY SERVICES

    REHABILITATION MEDICINE


    WOMEN'S HEALTH SERVICES

    CARDIOVASCULAR & PULMONARY SERVICES

    PROMOS & PACKAGES



    Reminder:

    The schedule is still subject to availability. Please wait for a call/email confirmation of your appointment within two (2) business days.
    We will also collect more specific information about your case or the type of service you need.


    In case of emergency, please call our OPD at 0956-523-2574.





    In submitting this form I agree to my details being used for the purposes of my electronic health record. I understand my data will be accessed by the necessary hospital staff and will not be distributed to third parties.*


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