AUTHORIZATION LETTER FOR PHILHEALTH

You can use this Authorization Letter for PhilHealth if you are updating or releasing any information about your PhilHealth member status. The sample and template below will help you to make your formal letter. But do not forget to indicate your own reason. You can use these format and give it to your bearer including your 2 valid IDs for their references.

Last Updated: July 30, 2019

AUTHORIZATION LETTER FOR PHILHEALTH




-SAMPLE-

July 25, 2016

Mrs. Julian M. Domingo
Finance Head
G/F Jomel Bldg III, P. Acosta St., cor. D. Samonte St.,
Brgy 14, Laoag City, Ilocos Norte

Dear Mrs. Domingo,

I am Jessica A. Peñaflor a resident of D. Samonte St., Laoag City, Ilocos Norte, a member of PhilHealth since May 16, 1998, and I hereby authorize the processing and release of my PhilHealth member information update with the Philhealth number 190001874512 to Mr. Ronaldo A. Peñaflor. I am needing it to secure my personal records at TCA Asia – C.A. Chabby Enterprises and change important information after updating it last September 2, 2002.

I am requesting your utmost cooperation and assistance on this issue.

Thank you so much and More Power.

Sincerely yours,
-signature-
Jessica A. Peñaflor



-FORMAT-

[DATE]
[NAME OF RECIPIENT]
[POSITION]
[ADDRESS]

Dear Ms./Mrs./Mr. [NAME OF RECIPIENT],

I am [YOUR NAME] a resident of [YOUR ADDRESS], a member of PhilHealth since [DATE WHEN YOU BECAME A MEMBER] and I hereby authorize the processing and release of my PhilHealth member information update with the Philhealth number [XX-XXXX] to Ms./Mrs./Mr. [NAME OF THE AUTHORIZED PERSON]. I am needing it to secure my personal records at [WHAT AGENCY OR COMPANY NEED YOUR MEMBER INFO UPDATE] and change important information after updating it last [DATE OF YOUR LAST UPDATE].

I am requesting your utmost cooperation and assistance on this issue.

Thank you so much and More Power.

Sincerely yours,

[SIGNATURE]
[YOUR NAME]



Note: You can use this sample if you are located only in the Philippines country. Do not copy the exact date, person, location and other details above. Remember that this is just a guide to you for creating your authorization letters.

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