• Select Hospital and Schedule

    Where and when would be the best fit schedule for you?
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  • Select Department

    Choose the services you wish to avail on us
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  • Total
    0.00 PHP

  • Patient Information

    Please fill all required fields.
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  • Philippine Residence

    Please fill all required fields.

  • Address Outside the Philippines

    (For Overseas Filipino Workers and Individuals with Residence outside the Philippines)

  • Travel History

    If you have travelled outside Philippines for the last 14 days.

  • Exposure History

    Have you been exposed to others with possible COVID-19.
  • Data Privacy Consent.
    By clicking the confirm button, I voluntarily and freely consent to the collection and sharing of the above personal information and recognizes that CebuDoc Group follows its responsibilities with regard to Republic Act No. 10173, otherwise known as the Data Privacy Act of 2012.
  • Electronic Signature Consent.
    By submitting this form, I hereby affirm that all data submitted are certified true and correct. Furthermore, my email address serves as my electronic signature and signifies my agreement to the terms and conditions stated on this form.

  • Booking Summary

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    1. Personal Information

    Selected Hospital:
    Name:
    Sex:
    Civil Status:
    Nationality:
    Booking Schedule:
    Date of Birth:
    Age:
    Occupation:
    Passport No:

    2. Philippine Residence

    Permanent Address:
    Home Phone No:
    Email Address:
    Current Address:
    Cellphone No.:

     3. Address Putside the Philippines
    (for Overseas Filipino Workers and Individuals with Residenec outside the Philippines)

    Are you an OFW? (Overseas Filipino Worker):
    Employer's Name:
    Place of Work:
    Work or Overseas Address:
    Do you have a residence outside the Philippines?:
    Occupation:
    Work Landline No.:
    Work Mobile No.:

    4. Travel History

    History of travel/visit/work in other countries with a known COVID-19 Transmission, 14 days before the onset of your signs and symptoms?
    Airline / Sea Vessel:
    Date of Departure (mm/dd/yyyy) :
    Port (Country) of Exit: 
    Flight / Vessel Number: 
    Date of Arrival in Philippines (mm/dd/yyyy):

    5. Exposure History

    History of exposure to known COVID-19 Transmission, 14 days before the onset of your signs and symptoms?
    Have you been in a place with a known COID-19 Transmission, 14 days before the onset of your signs and symptoms?
    Date when you have been in that place:
    If Yes, Date of Contact with Known COVID-19 Case (mm/dd/yyyy):
    If Yes, where:
    Name of the Place:

  • The information I have given is true, correct, and complete and by continuing to use this website, I voluntarily and freely consent to the collection and sharing of the above personal information under Republic Act 10173 or the Data Privacy Act of 2012 and other applicable governing laws on data collection and protection.

  • Payment Options

    Settle your bill here:
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  • GCASH Payment Instructions:

    1. Log in to your GCASH Account and select 'Send Money' then 'Send Money to Bank' or 'Bank Transfer.'
    2. Select BDO Unibank Inc., and fillout the required details needed to process your transaction.
      Account No: 2930014284
      Account Name: Cebu Doctors University Hospital, Inc.
      Amount : Php 
    3. On the confirmation page, confirm the amount of Php :
    4. The bank transfer should be processed immediately; you will receive an SMS confirmation receipt for the transaction.
    5. Take a screenshot of your transaction and upload your proof of payment below:

  • BDO Payment Instructions:

    1. Log in to your account and choose Send Money>To any BDO Account
    2. Fill-out the account information:
      Account No: 2930014284
      Account Name: Cebu Doctors University Hospital, Inc.
      Amount : Php 
    3. Enter your One-Time PIN* and confirm your transaction
    4. Take a screenshot of your transaction
    5. Upload your proof of payment below:
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