Cavite

For inpatient and discharged patient (from government hospitals and private health institutions)

1. Billing Statement
2. Promissory Note, (if discharged and if present)
3. Photocopy of prescription (if any) (the original must be seen by the Social Worker)
4. Photocopy of laboratory request (if any)
5. Photocopy of official receipt (the original must be seen by the Social Worker)
6. Brgy. Clearance
7. Photocopy of valid ID
8. Personal Letter to the Governor

For dialysis and chemotherapy patients:

1. Certified true copy of updated protocol
2. Photocopy of official receipt of last session (the original must be seen by the Social Worker)
3. Photocopy of laboratory request (if any)
4. Photocopy of prescription (if any)
5. Brgy. Clearance
6. Photocopy of valid ID
7. Personal Letter to the Governor

For maintenance medicine

1. Photocopy of prescription
2. Brgy. Clearance
3. Photocopy of valid ID
4. Personal Letter to the Governor

Note:

• • For maintenance medicine, client will be referred to PHO Annex for available medicine
  • If endowment assistance, requirements are same as before

• • • Must be a resident of Cavite Province for at least six (6) months and who are in dire need of financial assistance brought by sudden medical need, sudden loss of income and catastrophic events that hinder the social functioning of an individual, family or community.
    • Who completed the needed requirements

• • • Every 3 months, if patient is:
      • under chemotherapy and dialysis
      • hospitalized for more than 3 times within 6 months
    • Every 6 months, if patient has continuous medication and laboratory work ups

• • • Social workers will interview, assess and determine the financial assistance to be given/granted based on the Family’s Classification or family’s total monthly income.

• • • Original or Certified True Copy of Death Certificate
    • Original Brgy. Clearance of Claimant w/ original hand signature of Brgy. Captain
    • Photocopy of Valid I.D. of Claimant (eg. Voter’s I.D., Voter’s Certification, Postal I.D., NBI Clearance, Police Clearance)
    • Personal Letter addressed to the Governor