Download PMRF - PHILHEALTH MEMBER REGISTRATION FORM

UHC v.1 January 2020: A Step-by-Step Guide

The PhilHealth Member Registration Form (PMRF) is an essential document for registering, updating, or amending your PhilHealth membership details. This guide will help you understand its sections and how to complete it correctly.


I. Personal Details

This section gathers your basic information. Accuracy is key, so ensure all details match your official documents.

  • Date of Birth: Enter in dd-mm-yyyy format.
  • Citizenship: Specify whether you are Filipino or a Foreign National.
  • Sex: Indicate Male or Female.
  • Civil Status: Choose from Single, Married, Widow/er, or Annulled.
  • PhilSys ID Number (Optional): If you have a national ID, include its number.

II. Address and Contact Details

This section is divided into permanent and mailing addresses:

  • Permanent Home Address: Provide complete details, including house number, street name, subdivision, barangay, city/municipality, and ZIP code.
  • Mailing Address: Fill this in if different from your permanent address.
  • Contact Information:
    • Mobile number (mandatory for OFWs).
    • Home phone and business numbers (optional).
    • Email address (especially required for OFWs).

III. Declaration of Dependents

List all individuals eligible under your PhilHealth membership, including:

  • Spouse: Provide their full name and date of birth.
  • Children Under 21: Include their full names and dates of birth.
  • Parents (60+ Years): If they are fully dependent on you, they qualify.

Note: Dependents with permanent disabilities must be registered as principal members, per Republic Act 11228.


IV. Member Type

Identify your current membership type:

  1. Direct Contributors: Employed individuals (government or private), self-earning professionals, family drivers, and migrant workers.
  2. Indirect Contributors: Includes senior citizens, indigent members, and those sponsored by LGUs or NGAs.

Direct contributors must declare their profession, monthly income, and provide proof of income.


V. Updating/Amendment

For changes to your records, check the appropriate box and provide the necessary details. This includes:

  • Name corrections.
  • Updates to civil status or citizenship.
  • Addition/removal of dependents.
  • Corrections to contact or address details.

Reminders for Completing the PMRF

  1. Fill out the form in UPPER CASE/CAPITAL LETTERS.
  2. Write "N/A" for fields that don’t apply.
  3. Attach supporting documents, such as IDs, proof of income, or birth certificates, if required.
  4. Sign the form or provide your thumbmark if unable to sign.

Purpose of the PMRF

The PMRF serves multiple purposes:

  • Registration: For new members.
  • Updating/Amendments: For changes in personal or membership details.
  • Dependents Declaration: To add eligible dependents to your membership.

Why is the PMRF Important?

Your PhilHealth Identification Number (PIN) is unique and permanent. It is your key to accessing health benefits under the Universal Health Care (UHC) system. A complete and accurate PMRF ensures uninterrupted access to these services.

For further assistance, visit the PhilHealth website or your nearest branch.

Stay updated. Stay insured. Stay healthy!

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