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Rev1annexa B Personnel Eqpt

This document contains two annexes from the Republic of the Philippines Department of Health regarding regulatory requirements for health facilities. Annex A is a template for a list of facility personnel, requiring their name, position, qualifications, and licensure information. Annex B is a template for an equipment list, requesting the brand, model, serial number, and acquisition date for each piece of medical equipment owned by the applying facility.

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6K views2 pages

Rev1annexa B Personnel Eqpt

This document contains two annexes from the Republic of the Philippines Department of Health regarding regulatory requirements for health facilities. Annex A is a template for a list of facility personnel, requiring their name, position, qualifications, and licensure information. Annex B is a template for an equipment list, requesting the brand, model, serial number, and acquisition date for each piece of medical equipment owned by the applying facility.

Uploaded by

bon AREnas
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Republic of the Philippines

Department of Health
HEALTH FACILITIES AND SERVICES REGULATORY BUREAU

List of Personnel
Annex A
Name of Health Facility:____________________________________________________________________________________________
Complete Address :_____________________________________________________________________________________________

PRC STATUS
Specialty Board
Highest Educational

Contractual
Permanent
Certificate (for
Designation/ Attainment and
Name physicians), Reg. Validity Signature
Position Post Graduate Others, specify
specify No. Period
Course (if applicable)
(where applicable)

Use additional sheets when necessary


Annex A- List of Personnel
Revision:01
12082014
Republic of the Philippines
Department of Health
HEALTH FACILITIES AND SERVICES REGULATORY BUREAU

List of Equipment1
Annex B
Name of Health Facility:____________________________________________________________________________________________
Complete Address :_____________________________________________________________________________________________

Brand Name & Model Serial No. Quantity Date of Purchase

Use additional sheets when necessary


Annex B- List of Equipment
Revision:01
12/08/2014

1
Equipment should be present, functional, and owned by the hospital applying for license to operate.

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