VLDMC Health Connect App - A. Kanan Manpower Corp

Welcome to the VLDMC Health Connect App for A. Kanan Manpower Corp.

Investing in Your Client's Future: Providing convenient, safe, and reliable outpatient healthcare to support your clients' success.
Client Information

Please enter the correct details so that we can efficiently assess your particular requests and get in touch with you to confirm your schedule(s).
Endorsing Company
Authorized Company Representative (i.e. HR and/or Administrative Representative)

First NameMiddle NameLast Name
Official Designation/Title
Mobile Number
Please enter a valid phone number of the official representative endorsing the client.Format: (0000) 000-0000.
Email Address
Please enter a valid email address of the official representative endorsing the client.

Client Registration & Endorsement

Please indicate the services for each staff member being registered. Multiple services can be selected per employee based on your paritcular requirements.
Please specify the primary purpose of the endorsement below:
Please specify the number of clients you are registering and endorsing for this group appointment. You can register a minimum of 1 and a maximum of 10 clients per batch endorsement.
- Complete Name
  
  First Name(s)Middle NameLast NameSuffix
- Complete Address of Residence
  
  Complete Street Address and Barangay
  
  Street Address Line 2
  
  Town/CityProvince
  
  Postal / Zip Code
- Date of Birth
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearBirthdate
- Sex
- Phone Number
  Enter the client's valid mobile phone number.Format: (0000)-000-0000.
- Email Address
  Enter the client's valid email address.
- Billing Route & Payment Selection
- NOTICE: The candidate will be required to pay the full package fee at the VLDMC reception prior to medical exam administration.
- NOTICE: This transaction will be billed directly to A. Kanan Manpower Corp's corporate account under a 14-day settlement term.
- Please indicate the specific services required for this particular client.
  
  You may select multiple services as appropriate.
- You may select multiple services from the list of options on the left pane. Once selected, the services will move to the right pane, indicating the list of services being requested.
- Can't find the service(s) you're looking for?
  
  Specifying the service you require allows us to provide the best possible assistance.
- Please enter the specific service(s) that you would want to avail yourself of in the field provided below:
- Complete Name
  
  First Name(s)Middle NameLast NameSuffix
- Complete Address of Residence
  
  Complete Street Address and Barangay
  
  Street Address Line 2
  
  Town/CityProvince
  
  Postal / Zip Code
- Date of Birth
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearBirthdate
- Sex
- Phone Number
  Enter the client's valid mobile phone number.Format: (0000)-000-0000.
- Email
  Enter the client's valid email address.
- Billing Route & Payment Selection
- NOTICE: The candidate will be required to pay the full package fee at the VLDMC reception prior to medical exam administration.
- NOTICE: This transaction will be billed directly to A. Kanan Manpower Corp's corporate account under a 14-day settlement term.
- Please indicate the specific services required for this particular client.
  
  You may select multiple services as appropriate.
- You may select multiple services from the list of options on the left pane. Once selected, the services will move to the right pane, indicating the list of services being requested.
- Can't find the service(s) you're looking for?
  
  Specifying the service you require allows us to provide the best possible assistance.
- Please enter the specific service(s) that you would want to avail yourself of in the field provided below:
- Complete Name
  
  First Name(s)Middle NameLast NameSuffix
- Complete Address of Residence
  
  Complete Street Address and Barangay
  
  Street Address Line 2
  
  Town/CityProvince
  
  Postal / Zip Code
- Date of Birth
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearBirthdate
- Sex
- Phone Number
  Enter the client's valid mobile phone number.Format: (0000)-000-0000.
- Email
  Enter the client's valid email address.
- Billing Route & Payment Selection
- NOTICE: The candidate will be required to pay the full package fee at the VLDMC reception prior to medical exam administration.
- NOTICE: This transaction will be billed directly to A. Kanan Manpower Corp's corporate account under a 14-day settlement term.
- Please indicate the specific services required for this particular client.
  
  You may select multiple services as appropriate.
- You may select multiple services from the list of options on the left pane. Once selected, the services will move to the right pane, indicating the list of services being requested.
- Can't find the service(s) you're looking for?
  
  Specifying the service you require allows us to provide the best possible assistance.
- Please enter the specific service(s) that you would want to avail yourself of in the field provided below:
- Complete Name
  
  First Name(s)Middle NameLast NameSuffix
- Complete Address of Residence
  
  Complete Street Address and Barangay
  
  Street Address Line 2
  
  Town/CityProvince
  
  Postal / Zip Code
- Date of Birth
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearBirthdate
- Sex
- Phone Number
  Enter the client's valid mobile phone number.Format: (0000)-000-0000.
- Email
  Enter the client's valid email address.
- Billing Route & Payment Selection
- NOTICE: The candidate will be required to pay the full package fee at the VLDMC reception prior to medical exam administration.
- NOTICE: This transaction will be billed directly to A. Kanan Manpower Corp's corporate account under a 14-day settlement term.
- Please indicate the specific services required for this particular client.
  
  You may select multiple services as appropriate.
- You may select multiple services from the list of options on the left pane. Once selected, the services will move to the right pane, indicating the list of services being requested.
- Can't find the service(s) you're looking for?
  
  Specifying the service you require allows us to provide the best possible assistance.
- Please enter the specific service(s) that you would want to avail yourself of in the field provided below:
- Complete Name
  
  First Name(s)Middle NameLast NameSuffix
- Complete Address of Residence
  
  Complete Street Address and Barangay
  
  Street Address Line 2
  
  Town/CityProvince
  
  Postal / Zip Code
- Date of Birth
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearBirthdate
- Sex
- Phone Number
  Enter the client's valid mobile phone number.Format: (0000)-000-0000.
- Email
  Enter the client's valid email address.
- Billing Route & Payment Selection
- NOTICE: The candidate will be required to pay the full package fee at the VLDMC reception prior to medical exam administration.
- NOTICE: This transaction will be billed directly to A. Kanan Manpower Corp's corporate account under a 14-day settlement term.
- Please indicate the specific services required for this particular client.
  
  You may select multiple services as appropriate.
- You may select multiple services from the list of options on the left pane. Once selected, the services will move to the right pane, indicating the list of services being requested.
- Can't find the service(s) you're looking for?
  
  Specifying the service you require allows us to provide the best possible assistance.
- Please enter the specific service(s) that you would want to avail yourself of in the field provided below:
- Complete Name
  
  First Name(s)Middle NameLast NameSuffix
- Complete Address of Residence
  
  Complete Street Address and Barangay
  
  Street Address Line 2
  
  Town/CityProvince
  
  Postal / Zip Code
- Date of Birth
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearBirthdate
- Sex
- Phone Number
  Enter the client's valid mobile phone number.Format: (0000)-000-0000.
- Email
  Enter the client's valid email address.
- Billing Route & Payment Selection
- NOTICE: The candidate will be required to pay the full package fee at the VLDMC reception prior to medical exam administration.
- NOTICE: This transaction will be billed directly to A. Kanan Manpower Corp's corporate account under a 14-day settlement term.
- Please indicate the specific services required for this particular client.
  
  You may select multiple services as appropriate.
- You may select multiple services from the list of options on the left pane. Once selected, the services will move to the right pane, indicating the list of services being requested.
- Can't find the service(s) you're looking for?
  
  Specifying the service you require allows us to provide the best possible assistance.
- Please enter the specific service(s) that you would want to avail yourself of in the field provided below:
- Complete Name
  
  First Name(s)Middle NameLast NameSuffix
- Complete Address of Residence
  
  Complete Street Address and Barangay
  
  Street Address Line 2
  
  Town/CityProvince
  
  Postal / Zip Code
- Date of Birth
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearBirthdate
- Sex
- Phone Number
  Enter the client's valid mobile phone number.Format: (0000)-000-0000.
- Email
  Enter the client's valid email address.
- Billing Route & Payment Selection
- NOTICE: The candidate will be required to pay the full package fee at the VLDMC reception prior to medical exam administration.
- NOTICE: This transaction will be billed directly to A. Kanan Manpower Corp's corporate account under a 14-day settlement term.
- Please indicate the specific services required for this particular client.
  
  You may select multiple services as appropriate.
- You may select multiple services from the list of options on the left pane. Once selected, the services will move to the right pane, indicating the list of services being requested.
- Can't find the service(s) you're looking for?
  
  Specifying the service you require allows us to provide the best possible assistance.
- Please enter the specific service(s) that you would want to avail yourself of in the field provided below:
- Complete Name
  
  First Name(s)Middle NameLast NameSuffix
- Complete Address of Residence
  
  Complete Street Address and Barangay
  
  Street Address Line 2
  
  Town/CityProvince
  
  Postal / Zip Code
- Date of Birth
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearBirthdate
- Sex
- Phone Number
  Enter the client's valid mobile phone number.Format: (0000)-000-0000.
- Email
  Enter the client's valid email address.
- Billing Route & Payment Selection
- NOTICE: The candidate will be required to pay the full package fee at the VLDMC reception prior to medical exam administration.
- NOTICE: This transaction will be billed directly to A. Kanan Manpower Corp's corporate account under a 14-day settlement term.
- Please indicate the specific services required for this particular client.
  
  You may select multiple services as appropriate.
- You may select multiple services from the list of options on the left pane. Once selected, the services will move to the right pane, indicating the list of services being requested.
- Can't find the service(s) you're looking for?
  
  Specifying the service you require allows us to provide the best possible assistance.
- Please enter the specific service(s) that you would want to avail yourself of in the field provided below:
- Complete Name
  
  First Name(s)Middle NameLast NameSuffix
- Complete Address of Residence
  
  Complete Street Address and Barangay
  
  Street Address Line 2
  
  Town/CityProvince
  
  Postal / Zip Code
- Date of Birth
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearBirthdate
- Sex
- Phone Number
  Enter the client's valid mobile phone number.Format: (0000)-000-0000.
- Email
  Enter the client's valid email address.
- Billing Route & Payment Selection
- NOTICE: The candidate will be required to pay the full package fee at the VLDMC reception prior to medical exam administration.
- NOTICE: This transaction will be billed directly to A. Kanan Manpower Corp's corporate account under a 14-day settlement term.
- Please indicate the specific services required for this particular client.
  
  You may select multiple services as appropriate.
- You may select multiple services from the list of options on the left pane. Once selected, the services will move to the right pane, indicating the list of services being requested.
- Can't find the service(s) you're looking for?
  
  Specifying the service you require allows us to provide the best possible assistance.
- Please enter the specific service(s) that you would want to avail yourself of in the field provided below:
- Complete Name
  
  First Name(s)Middle NameLast NameSuffix
- Complete Address of Residence
  
  Complete Street Address and Barangay
  
  Street Address Line 2
  
  Town/CityProvince
  
  Postal / Zip Code
- Date of Birth
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearBirthdate
- Sex
- Phone Number
  Enter the client's valid mobile phone number.Format: (0000)-000-0000.
- Email
  Enter the client's valid email address.
- Billing Route & Payment Selection
- NOTICE: The candidate will be required to pay the full package fee at the VLDMC reception prior to medical exam administration.
- NOTICE: This transaction will be billed directly to A. Kanan Manpower Corp's corporate account under a 14-day settlement term.
- Please indicate the specific services required for this particular client.
  
  You may select multiple services as appropriate.
- You may select multiple services from the list of options on the left pane. Once selected, the services will move to the right pane, indicating the list of services being requested.
- Can't find the service(s) you're looking for?
  
  Specifying the service you require allows us to provide the best possible assistance.
- Please enter the specific service(s) that you would want to avail yourself of in the field provided below:

Appointment Scheduler

Please note that the appointment slot you choose will be treated as provisional until it is confirmed. After completing and submitting your request(s) and/or preference(s), a member of VLDMC's Medical Concierge Team will promptly reach out to you directly to confirm the schedule.
Please choose your preferred schedule by selecting a specific date and time below.
Preferred Schedule

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option

Agency Endorsement Confirmation & Authorization

Final step: Please review and sign below to authorize this candidate endorsement batch. This final section serves as the binding authorization for all candidates listed in this submission. Ensure all selected health packages and billing routes are accurate prior to signing.
By submitting this endorsement form, I hereby declare and confirm that I am an authorized representative of A. Kanan Manpower Corporation. I certify that all individuals listed above are official candidates of our agency endorsed for pre-employment medical examination.

Our agency acknowledges full accountability and secondary legal/financial liability for the referral, selection of services, and payment terms governing these clients in accordance with our executed Memorandum of Agreement with Vicente L. Danguilan Memorial Clinic (VLDMC).
Digital Signature of Endorsing Representative
Should be Empty:

Welcome to the VLDMC Health Connect App for A. Kanan Manpower Corp.

Client Information

Client Registration & Endorsement

Please indicate the specific services required for this particular client.

Can't find the service(s) you're looking for?

Please indicate the specific services required for this particular client.

Can't find the service(s) you're looking for?

Please indicate the specific services required for this particular client.

Can't find the service(s) you're looking for?

Please indicate the specific services required for this particular client.

Can't find the service(s) you're looking for?

Please indicate the specific services required for this particular client.

Can't find the service(s) you're looking for?

Please indicate the specific services required for this particular client.

Can't find the service(s) you're looking for?

Please indicate the specific services required for this particular client.

Can't find the service(s) you're looking for?

Please indicate the specific services required for this particular client.

Can't find the service(s) you're looking for?

Please indicate the specific services required for this particular client.

Can't find the service(s) you're looking for?

Please indicate the specific services required for this particular client.

Can't find the service(s) you're looking for?

Appointment Scheduler

Agency Endorsement Confirmation & Authorization