Register as Partner Doctor

First Name

Last Name

Email

Mobile Number

PRC License Number (Optional)

Specialization

Select or type specialization

Hospital/ClinicPlease select 'Other' if you can't find your hospital/clinic in the list.

Philippine General Hospital

Clinic Hours

Clinic Contact Number

Street Address

Province

Select province

City

Select city

Full NamePlease provide the full name of the Medical Representative or Product Specialist who referred you to the program.

On a scale of 1 to 10, how satisfied are you with the enrollment process?

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What improvements would you suggest for the CarePlus enrollment process?