Get Preliminary Survey Report - Philcarecomph

Filling out the PRELIMINARY SURVEY REPORT - Philcarecomph online is a straightforward process that helps in the effective management of your healthcare franchise application. This guide provides a clear approach to complete each section of the form accurately and efficiently.

Follow the steps to complete your survey report easily.

1. Click the ‘Get Form’ button to access the form and open it in your preferred editing tool.
2. Begin by filling in the full name of your company and indicating any sister companies or affiliates if applicable.
3. Provide the complete address of the company, including street, city, state, and zip code.
4. Specify the nature of your business and provide relevant contact details including telephone number, fax number, and email address.
5. Enter the contact person's name and their designation or position within the company.
6. List the proposal addressee along with their designation or position.
7. Identify the decision-maker(s) along with their corresponding designations or positions.
8. Select the coverage classification that applies to your company’s health plan options.
9. Fill in the total number of regular employees or principal members, total number of dependents, and any special arrangements if applicable.
10. Indicate whether the employees are covered by SSS/Philhealth and if you have a previous carrier, specifying the HMO name if applicable.
11. In the conforme section, fill in the expiry date and ensure that the agent/broker signature and details are completed.
12. Once all the information is correctly filled out, you can save your changes, download the file, print it, or share it as needed.

Complete your PRELIMINARY SURVEY REPORT - Philcarecomph online today for a smoother franchise application process.