HealthServ Online Consultation Request
To all our patients!

We know that some of you are in need of their urgent check-up and we want to help. We are now open for ONLINE CONSULTATION.

Just fill up the form below for appointment registration and we will send you a link and a schedule for your online consultation.

Please stay at home as we are in the midst of a global crisis. We are just a video call away to serve you.

Reminder:
1. Online Consultation Coordinator will answer inquiries/registrations during office hours (8am to 5pm) only.
2. Online Consultation (OLC) Schedules are to be verified with the doctor first.
3. OLC fees vary.
4. OLC targets to aid minor and primary non-emergency cases. For urgent care, please call our Emergency Room at (049) 536-4858 local 112/621 or 0917-301-6646.

DISCLAIMER: Please be reminded that requests made beyond office hours will be processed on the next business day.

Stay Home and Stay Safe
Here to Serv,
HealthServ Los Banos Medical Center

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Full Name *
Buong Pangalan
Age *
Edad
Civil Status *
Katayuang Sibil
Birth Date *
Araw ng kapanganakan
Address *
Kinatatahanan
Social Media or Messenger Accounts (eg., jdelacruz@yahoo.com or Facebook Name, Viber Phone Number, WhatsApp Phone Number)
Phone number *
Numero ng telepono
Who is your Doctor
Pangalan ng bibisitahing Doctor
Health problem for consultation
Karamdaman na ipapa-konsulta
Patient type *
Uri ng pasyente
Mode of Payment
Paraan ng pagbabayad
Other Details / Remarks
Karagdagang detalye
To our Dear Patients,
Thank you for your continued support with HealthServ LBMC. Despite of this current COVID-19 pandemic that we are all fighting, we would like to reach out and be of service to you.

Should you wish to have your online consultation done, below are the payment details that we can use.

Kindly wait for confirmation from the Online Consultation Coordinator as to the amount to settle. Fees differ depending on the doctor.

Bank: BANK OF THE PHILIPPINE ISLANDS
Account Number: 0911-0136-06
Branch: Los Baños

Bank: METROBANK
Account Number: 485-7-485-90930-0
Branch: Los Baños

Bank: BANCO DE ORO
Account Number: 005108000326
Branch: Los Baños

Bank: SECURIY BANK
Account Number: 0221-041096-001
Branch: Calamba

Bank: EQUICOM SAVINGS
Account Number: 0005-01-00176-4
Branch: Calamba

You may attach or send the proof of payment below.
Viber: 09267163291
Portal: https://www.facebook.com/HSLBDoctorsPortal
Mobile: 09267163291
Reminder: Please inform OLC Coordinators after submitting proof of payments

Once again, thank you for your support.
Here to Serv,
HealthServ LBMC

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