CEBU DOCTOR'S UNIVERSITY HOSPITAL ONLY

OUT PATIENT LOA REQUEST
Lastname
Firstname
Middlename
Date of Birth
Email
Contact No.
HMO Provider
PURPOSE (What is the LOA for?)
Date (When to use the LOA?)
FOR Consultation, who is your Physician/Doctor?
For Procedure/Diagnostics, please attach your doctor's order/prescription.
Insurance Card and Valid ID/Company ID




cebudoc
Osmeña Blvd., Cebu City
+63 032 255-5555

mactandoc
Basak, Lapu-lapu City
+63 032 2397002 to 7016

northgen
Talamban, Cebu City
+63 032 343-7777

sancarlosdoc
San Carlos City, Negros Occidental
+63 034 312-5136

southgen
City of Naga, Cebu
+63 032 272-2223

ormocdoc
Ormoc City, Leyte
+63 053 255-7522

Contacts

Email: info@cebudocgroup.com
Phone: 032 255-5555

Feedback

Please send us your ideas, bug reports, suggestions! Any feedback would be appreciated.