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    POAF (Employer)

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    Youka Main
    This document is a PhilHealth online access form containing fields for an employer's name, address, contact details, and the name and details of their PhilHealth Employers Engagement Representative. It also includes sections for PhilHealth to record the date of registration, orientation, processing, and the systems and roles the employer will have access to online.

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    POAF (Employer)

    Uploaded by

    Youka Main
    733 views1 page
    This document is a PhilHealth online access form containing fields for an employer's name, address, contact details, and the name and details of their PhilHealth Employers Engagement Representative. It also includes sections for PhilHealth to record the date of registration, orientation, processing, and the systems and roles the employer will have access to online.

    Original Description:

    Philhealth POAF AUGUST 2012 REV

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    This document is a PhilHealth online access form containing fields for an employer's name, address, contact details, and the name and details of their PhilHealth Employers Engagement Representative. It also includes sections for PhilHealth to record the date of registration, orientation, processing, and the systems and roles the employer will have access to online.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    733 views1 page

    POAF (Employer)

    Uploaded by

    Youka Main
    This document is a PhilHealth online access form containing fields for an employer's name, address, contact details, and the name and details of their PhilHealth Employers Engagement Representative. It also includes sections for PhilHealth to record the date of registration, orientation, processing, and the systems and roles the employer will have access to online.

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    © All Rights Reserved
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    of 1

    Annex “B”

    Series No. Date


    PHILHEALTH ONLINE ACCESS FORM
    Revised POAF Form No. 001, August 2012

    Name of Employer Philhealth Employer Number (PEN)

    Business Address Philippine Standard and Division Code Station Code


    Geographic Coding (PSGC)

    Name and Signature of Head of Office Position Email Address Telephone No. / Mobile No.

    Name of Philhealth Employers Engagement Position of PEER Email Address Mobile Number
    Representative (PEER)

    PEER Company/Agency No. Telephone No.

    To be filled-out by Philhealth

    Registration Date Regional / Branch Office LHIO Orientation Date

    Processed Date Processed By System to be Accessed Role Assigned

    Annex “B”
    Series No. Date
    PHILHEALTH ONLINE ACCESS FORM
    Revised POAF Form No. 001, August 2012

    Name of Employer Philhealth Employer Number (PEN)

    Business Address Philippine Standard and Division Code Station Code


    Geographic Coding (PSGC)

    Name and Signature of Head of Office Position Email Address Telephone No. / Mobile No.

    Name of Philhealth Employers Engagement Position of PEER Email Address Mobile Number
    Representative (PEER)

    PEER Company/Agency No. Telephone No.

    To be filled-out by Philhealth

    Registration Date Regional / Branch Office LHIO Orientation Date

    Processed Date Processed By System to be Accessed Role Assigned

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