MEMORANDUM OF AGREEMENT
This Memorandum of Agreement executed on this _____
- ________ at Silang Cavite, Philippines by and between.
JULLIENNE LYING-IN AND MATERNITY CLINIC
, a business entityduly registered with the Department of Trade and Industry with businessaddress at Block 36 Lot 9 Xone 11 AFP Housing, Bulihan, Silang, Caviteand represented by the ownier / sole proprietor
, hereinafter referred to as the “
NAME OF HOSPITAL
, a medical and a corporate entity duly registeredin accordance with the laws of the Republic of the Philippines withbusiness at KM 43 By Pass, Silang, Cavite represented by its MEDICALDIRECTOR,
NAME OF DOCTOR/OWNER
, hereinafter referred to as the
NAME OF OB-GYNE,
a medical practitioner (
) with licensed number_______, and
, a medical practitioner (
) with License No. ________, both are presently affiliated at name of hospital, hereinafterreferred to as the “
”.WitnessethWHEREAS, Jullienne Lying-In and Maternity Clinic (SERVICEPROVIDER) is engaged in the service of providing maternity care topregnant women offering prenatal, midwife-assisted delivery and postnatal care to mothers and newborns;WHEREAS, there are onset risk cases which the SERVICE PROVIDERcan handle better with the help of professional medical practitioners afterexamination of patients and determination that they will require furtheradept medical supervision for both mothers and newborns;WHEREAS, the parties herto – the SERVICE PROVIDER and PARTNERPHYSICIANS forge a partnership concerning onset risk cases to facilitatepatients admission to the REFERRAL HOSPITAL bearing in mind the bestinterest of the mother and the unborn or newborn, as the case may be;WHEREAS, all onset risk cases handled by herein SERVICEPROVIDER and PARTNER PHYSICIANS shall be exclusively referred to theREFERRAL HOSPITAL subject to Philhealth membership of patients orbeneficiaries;WHEREAS, the trilateral relationship is meant to maximize theMaternity Care Package available to Philhealth members and theirbeneficiaries and make available its availment to a wider patient base;WHEREAS, essentially, the purpose of this Memorandum of Agreement is to extend the REFERRAL HOSPITAL’S accreditation use tothe SERVICE PROVIDER in relation to onset risk cases.