Welcome to VRPMC's In-Clinic Consultation and Diagnostic Appointment

Welcome to VRPMC's In-Clinic Consultation and Diagnostic Appointment

Need an appointment for test or doctor's consultation? You're just a few clicks away!

TEST / PROCEDURE APPOINTMENT

Fill out the required fields.
Center to Visit*
Chief complaint / History*
Requested Procedure*
Diagnosis*
Requesting Doctor*
Attach Doctor's Request*

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Preferred Date and Time of Online Consultation*

MonthDayYear
Date
Hour MinutesAM/PM Option

PATIENT INFORMATION

Please provide your correct information. This will be used for your registration.
Name*

First NameMiddle NameLast Name
Gender*

FemaleMale
Civil Status*

SingleMarriedWidowedLegally Separated
Address*

House No., Street, Village

Street Address Line 2

BarangayCity / Province

Zip CodeCountry
Birthday*

MonthDayYear
Date
Viber Number*
Example: 0912-345-6789
Email*
example@example.com
Are you a Senior Citizen or a PWD?*

No, I am a regular patient.Senior CitizenPerson with Disability (PWD)
Senior Citizen or PWD ID No.*
Please bring your Senior Citizen ID/PWD ID during your visit for validation.
Attach Senior/PWD ID (Front)*

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Attach Senior/PWD ID (Back)*

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Valid ID*

Please upload a copy of the cardholder's Valid ID.
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PAYMENT PROCEDURE
Payment Type*

HMOSelf pay
Select HMO*
Please select your HMO and be ready to upload your Valid ID and HMO Card.
Name of Cardholder*
Company Name*
HMO Card/ID Number*
HMO Card*

Please upload a copy of the cardholder's HMO card.
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WAIT FOR CONFIRMATION!

Our Digital Concierge Officer will be in touch to confirm your appointment. Please provide the name of the patient, preferred date and time of consultation and name of the doctor/specialization. Once the appointment has been confirmed, payment instructions will be sent to your designated Viber number. Thank you for choosing our services!
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APPOINTMENT DETAILS