New Affiliation

This will guide you on the process of applying for an affiliation with Maxicare. Read the instructions carefully and proceed to fill up the form found on the link on Step 3 below.

Step 1: Make a copy and download the following documents required for the affiliation.

1. Physician Affiliation Agreement  (Click Here)

Step 2: Prepare the following documents required for applying a new affiliation. Soft copies may be required to be attached in the form.

1. Copy of Fellow or Diplomate Certificate

2. Copy of Fellow or Diplomate Certificate for Sub-specialization

3. Copy of PRC License

4. Copy of PHIC License

5. BIR Certificate of Registration (Form 2303)

6. Copy of Bank Statement

7. Curriculum Vitae or Resume

8. Duly Signed Physician Affiliation Agreement

Step 3: Click here to register

Step 4: Wait for the confirmation coming from our Maxicare Provider Relations Officer.

Need assistance? For inquiries, you may email us at provider.medical@maxicare.com.ph