Requirements for Medical and Surgical Assistance

The following are requirements on Application for Treatment:

  1. Accomplished Application Form and Waiver Form (click to download);
  2. Birth Certificate (Photocopy);
  3. Pictures showing deformities/ illness (at least 3);
  4. Barangay Certificate of Indigence;
  5. DSWD Certificate of Indigence and/or Case Study Report;
  6. PhilHealth ID Card (Photocopy) and Member Data Record (indicating that applying patient for treatment is one of the beneficiaries);
  7. Medical Abstract, Laboratory etc., (if available):
  8. Endorsement of a Lodge (signed by Worshipful Master and/or Secretary);

Additional requirements:

  1. Initial Examination, Recommendation, Cost Estimate by MCCCI Medical Director or Accredited Specialist;
  2. Approval of the Board of Trustees;
  3. Post-operation photos must be submitted after treatment.