PMRF Form

What is a PMRF Form

The PMRF Form of PhilHealth is a two-page application that Filipino citizens can use to become a member of the local insurance program. You need to obtain a PhilHealth Identification Number before filling it out. You do not need other documents.

What do I need the PMRF Form in PhilHealth for?

• Use the PhilHealth PMRF Form to apply for membership in the PhilHealth program.
• This same form should be used if there has been any change in your personal data and you need to update or amend information that you previously provided.
• Non-citizens of the country can also partake in the insurance program, but they need to complete the PMRF-FN.

How to Fill Out PhilHealth Form PMRF

1. Enter your PIN and preferable healthcare provider and select the purpose of filling out the document: registration or making changes to personal information.

2. Write your full name, as well as the maiden name of your mother and spouse (if you are married).

3. Enter date and place of birth, gender, citizenship, civil status, TIN, and PhilSys ID Number.

4. Provide information about your registration and mailing addresses and enter all your contact details.

5. If you have dependents, fill in their information in the appropriate block of the PMRF Form PDF. If not, indicate “not applicable.”

6. Select the type of membership and indicate your occupation and income.

7. If you need to correct the previous form, select the type of correction in the last paragraph.

8. Date and sign (or thumbprint) the PhilHealth PMRF Form, download it, and print it or email it to the recipient.