Premiere Medical & Cardiovascular Laboratory

If you are an HMO Card holder, we have great news for you! No need to wait long for approval. We can now process your HMO request for any laboratory procedures simly by completing the online form. you will receive a confirmation message once your HMO request has been approved.

Note:

You will be required to upload your valid ID, HMO Card, and test request issued by an HMO accredited doctor with corresponding diagnosis. Unmatched details may result in delay of approval. We will contact you to verify some information if necessary. For some HMO, additional information will be required for verification purposes.
Submission of this request form should be at least 2 days before the scheduled date.
Validity of approved request is within 3 days only.
You will receive a confirmation email once your request has been successfully received. Please bear in mind that you will receive another confirmation email or phone call from our staff once your booking and approval have been confirmed.

Patient Details

Name

Gender

Email Address

Valid ID Number

Type of Valid ID

Date of Birth

Contact Number

Upload Valid ID

HMO Details

HMO Card

HMO ID/Policy Number

Doctor's Full Name

Doctor's Request

HMO Card Image

Company Name

Specialization

Clinic Address/Hospital Affiliation

Diagnosis

Set An Appointment

Branch

Preferred Date of Visit

Online HMO Approval

Note:

Patient Details

HMO Details

Set An Appointment