Negros Polymedic Hospital, Philippines Mon & Fri- 8AM-12NN; Tues- 1-4PM
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+63 917 525 1699
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vincentmartinbravo@gmail.com

YOUR SAFETY IS OUR PRIORITY.
Please fill up the information on this form with honesty and full transparency as a requirement in booking your appointment; this will help us give you the safest treatment possible as well as to fight the spread of the coronavirus.
We appreciate your cooperation and understanding. Thank you.


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I hereby certify, by attaching my full name digitally, that the information submitted in this application is true and correct to the best of my knowledge.