DOCUMENTARY REQUIREMENTS FOR MEDICAL AND SURVIVORSHIP ASSISTANCE

FOR MEDICAL ASSISTANCE

1. Endorsement letter signed by the local chief executive (LCE)

Note: strictly follow the addressee below:

AZUCENA M. DAYANGHIRANG, MD, MCH, CESO III

Assistant Secretary and Executive Director
National Nutrition Council
Nutrition Building, 2332 Chino Roces Avenue Extension
Taguig City

Through: GLADYS MAE S. FERNANDEZ

Nutrition Program Coordinator, NNC X

2. Certified True Copy of BNS Masterlist (Signed by MNAO)

3. Photocopy of one (1) valid ID of BNS
4. Letter request of BNS applicant

Note: strictly follow the addressee below:

AZUCENA M. DAYANGHIRANG, MD, MCH, CESO III

Assistant Secretary and Executive Director
National Nutrition Council
Nutrition Building, 2332 Chino Roces Avenue Extension
Taguig City

Through: GLADYS MAE S. FERNANDEZ

Nutrition Program Coordinator, NNC X

5. Document must indicate medical condition, dates of hospital confinement and hospital of
confinement.
- In case the BNS was admitted in a private hospital, a justification letter must be signed
by the NAO.

6. For COVID-19 Positive BNS:

• Same requirements to regular Medical Assistance Requirements:
- Endorsement letter signed by the Local Chief Executive (LCE)
- Certified True Copy of BNS Masterlist
- Photocopy of one (1) valid ID of BNS
- Letter request of BNS applicant
• Completed the required quarantine/isolation control
• Medical certificate or certification from the Isolation Unit/Quarantine Manager
 FOR SURVIVORSHIP ASSISTANCE
1. Endorsement letter signed by the local chief executive (LCE)

Note: strictly follow the addressee below:

AZUCENA M. DAYANGHIRANG, MD, MCH, CESO III

Assistant Secretary and Executive Director
National Nutrition Council
Nutrition Building, 2332 Chino Roces Avenue Extension
Taguig City

Through: GLADYS MAE S. FERNANDEZ

Nutrition Program Coordinator, NNC X

2. Letter request of beneficiary of deceased BNS

Note: strictly follow the addressee below:

AZUCENA M. DAYANGHIRANG, MD, MCH, CESO III

Assistant Secretary and Executive Director
National Nutrition Council
Nutrition Building, 2332 Chino Roces Avenue Extension
Taguig City

Through: GLADYS MAE S. FERNANDEZ

Nutrition Program Coordinator, NNC X

3. Certified True Copy of BNS Masterlist

4. Photocopy of one (1) valid ID of deceased BNS

5. Photocopy of one (1) valid ID of BNS’ beneficiary (If spouse, include marriage contract)
6. Certified True Copy of death certificate

Medical Assistance – Php. 5, 000.00

Survivorship Assistance – Php. 20, 000.00

NOTE:
Please send an advance copy of your documentary requirements to NNC X’s email address
(region10@nnc.gov.ph or NNC_X@yahoo.com); for appraisal, before you send out the original
documents via courier.