Selection of Beneficiary

CRITERIA

1. No applicant will be denied for medical financial assistance if has been diagnosed with spina bifida by Dr. David Bolong

2. All patients should be medically assessed by Dr. David Bolong.

3. Referrals should come from Dr. David Bolong or physician in charge

REQUIREMENTS

1. Filled up MFA Application Form with Medical Financial Assessment from SBSGF Assessment Committee

2. 1 pc. of 2x2 recent ID picture

3. Medical assessment / abstract/ certificate from Dr. David Bolong

4. Barangay Certificate

5. Copies of previous 3-months payslip of the applicant / parents (if any)

6. Copies of income tax return

SBSGF Membership Application - Assistance Form.docx

Download DOCX • 40KB