NCMH CTZ Charter 2023 5

REPUBLIC OF THE PHILIPPINES
Department of Health
National Center for Mental Health
NATIONAL CENTER FOR MENTAL HEALTH

CITIZEN’S CHARTER
2023 (5th Edition)
1
I. Mandate
The National Center for Mental Health is categorized as Special Research Training
Center and Hospital under the Department of Health on January 30, 1987, and is
dedicated to delivering preventive, curative and rehabilitative mental health care services.
The passage of the Universal Health Care Act designates NCMH as National Specialty
Center for Mental Health, to design and develop service delivery standards in partnership
with other stakeholders. As indicated in the DOH-developed Resource Stratified
Framework, NCMH, as the country’s apex or end-referral facility for mental health care,
must deliver the highest level expertise in clinical services, teaching and training, and
research in mental health care.
Similarly, with the passage of the Mental Health Act, NCMH being the premiere training
and research center, was mandated to expand its capacity for research and development
of interventions on mental and neurological services in the country. NCMH, a Level 3
specialty hospital with the highest level of expertise, is directed to provide comprehensive
health programs with focus on research, training, and rights-based psychiatric,
neurologic, and psychosocial services.
II. Vision
“The NCMH is an internationally recognized Mental Health Reference Center leading the
advancement of mental well-being for all.”
III. Mission
“To lead the country in providing comprehensive mental healthcare services through
integrated clinical practice, training, and research.”
IV. Service Pledge
We, the officials and employees of the National Center for Mental Health pledge and
commit to deliver quality mental health services to the public. Specially, we will:
▪ Serve with integrity;
▪ Be prompt and timely;
▪ Display procedures, fees, and charges;
▪ Provide adequate and accurate information;
▪ Be consistent in applying rules;
▪ Provide feedback and mechanism;
▪ Be polite and courteous;
▪ Demonstrate sensitivity and appropriate behavior and professionalism;
▪ Wear proper uniform and identification; and
▪ Be available during office hours.
2
PART I: EXTERNAL SERVICES
AGENCY PROFILE PAGE
I. Mandate 2
II. Vision 2
III. Mission 2
IV. Service Pledge 2
SERVICES UNDER THE MEDICAL CENTER CHIEF OFFICES
1. Application for Clinical Rotation for Student Affiliates 7

2. Application for Psychiatry Residency Training 9
3. Filing and Handling of Concerns 10
4. Handling Complaint 12
5. Handling of Letters/Correspondence Received through Email/
Courier/Personal Deliveries 13
6. Provision of Technical Assistance on Mental Health Programs 14
7. Request for Approval of a System for Handling Personal Information 16
8. Research Data Site Collection 17
9. Request for FOI Information 18
10. Request for Incidental Crisis and Structured Emergency Response 19
11. Request for Technical Assistance on Mental Health Programs (PHU) 21
12. Request for Training Assistance (Basic Life Support and Standard First Aid) 22
13. Research/Thesis Technical Review 23
PATIENT CARE SERVICES
14. Admission Process for Non-Psychiatric Patients 25

15. Admission to Psychiatric Ward 26
16. Admission/Trans-In Process for Psychiatric Patients 28
17. Consultation of Presumptive TB Case 29
18. Dental Consultation and Management 31
19. Discharge Process for Psychiatric Patients 35
20. Dispensing of Medical Supplies 37
21. Emergency Care and Management for Non-Psychiatric Patients 46
22. Emergency Care and Management for Psychiatric Patients 48
23. Forensic Psychiatry Consultation 49
24. Hemodialysis Treatment for In-Patients 50
25. Hemodialysis Treatment for Out-Patients 52
26. OPD Consultation for In-Patients 54
27. OPD Consultation for Out-Patients and NCMH Employees 55
28. Operating Room Procedure for In-Patients 56
29. Psychiatric Emergency Care and Management 57
30. Psychiatric Out-Patient Consultation 59
31. Psychiatric Out-Patient Online Consultation 61
32. Request for Refill of Medications (ROM) 62
33. WCPU Follow-Up Consultation 63
34. WCPU Initial Consultation 64
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MEDICAL ANCILLARY SERVICES PAGE
35. Accessing Health Care Information of In-Patients and Out-Patients 65

36. Clinical Laboratory Examinations for In-Patients 66
37. Clinical Laboratory Examinations for Out-Patients and NCMH Employees 68
38. Computed Tomography Scan (CT scan) 72
39. COVID-19 RT-PCR Collection and Testing 75
40. Dispensing of Drugs and Medicines 77
41. Drug Testing 84
42. Electroencephalogram (EEG)/Electromyogram and Nerve Conduction
Velocity (EMG-NCV) 86
43. Histopathology Services 87
44. Malasakit Center Medical Assistance 89
45. Neuropsychiatric Assessment and Psychological Testing 91
46. Nutrition Consultation 93
47. Occupational Therapy Services 94
48. Personal Grooming Services 95
49. Physical Therapy for In-Patients 96
50. Physical Therapy for Out-Patients and NCMH Employees 97
51. Processing and Issuance of Hospital Statistical Data Requests for
Research Purposes 98
52. Psychological Assessment for Out-Patients 99
53. Releasing of Birth Certificate 101
54. Releasing of Cadaver 102
55. Request for Correction and Updating of Patient Information 103
56. Request to Access Health Records 104
57. Requisition and Issuance of Medical Records (In-Patients) 105
58. Requisition and Issuance of Medical Records (Out-Patients) 107
59. Respiratory Therapy Services 109
60. Spiritual Care Services 110
61. X-Ray and Ultrasound Services 111
HOSPITAL OPERATIONS AND PATIENT SUPPORT SERVICES
62. Hiring Process 114

63. Procurement of Goods, Infrastructure, and Consulting Services 116
FINANCE SERVICE
64. Processing of BIR Form 2307 126

65. Request for a Copy of Paid Disbursement Voucher (DV) for Request
of Retention 128
66. Request for Billing Statement 129
67. Request for Philhealth Electronic Member Registration and Records
Amendment (EMRRA) 130
68. Request for Philhealth Member Eligibility 131
4
PART II: INTERNAL SERVICES
SERVICES UNDER THE MEDICAL CENTER CHIEF OFFICES PAGE
1. Application for Advanced Professional Courses 133

2. Application for Study Leave 135
3. Infrastructure Work Request 136
4. Issuance of Certificates for Learning and Development Activities 138
5. Issuance of Certificates for Student Affiliates 139
6. Processing of Document Request Form 140
7. Provision of Data Allowance for Learning and Development Activities 142
8. Request for Certificate of No Pending Case/Certificate of Good Moral 143
9. Research Grants 144
10. Training Enrollment/In-House/Consulting Services 145
MEDICAL ANCILLARY SERVICES
11. Application for COVID-19 Sickness and Death Compensation for

Eligible NCMH Employees 146
12. Risograph 149
HOSPITAL OPERATIONS AND PATIENT SUPPORT SERVICES
13. Appointment Process 150

14. Compensatory Time-Off 152
15. Issuance of Authority to Travel 153
16. Issuance of Gate Pass 154
17. Issuance of NCMH Identification Card 155
18. Issuance of Supplies and Equipment 156
19. Leave Application 157
20. Maintenance Work Request 159
21. MPL Pag-Ibig Loan Application 161
22. Pag-Ibig Contribution Adjustment 162
23. Processing of Salary 163
24. Request for I.T Services 165
25. Request for Laundry Services 166
26. Request for Linen Services 167
27. Request for Loan Balances 168
28. Request for Memo/H.O, and other Issuances 169
29. Request for Monthly Payslip 170
30. Request for Philhealth Contribution 171
31. Request for Sanitation Works 172
32. Request for Security Assistance 173
33. Request for Transport Services 174
34. Requisition of Service Record and Certificate of Employment 175
35. RFID Application 176
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FINANCE SERVICE PAGE
36. Application for Bond of Accountable Public Officer 177

37. Issuance of Certificate of Availability of Funds (CAF) 178
38. Late Filing of BIR Form 2316 179
39. Per Diem Claims 180
40. Replenishment of Petty Cash Funds/ Liquidation of Petty Cash
Funds and Cash Advances/ Reimbursement of Expenses 182
41. Request for Petty Cash Fund and Cash Advance 185
6
1. APPLICATION FOR CLINICAL ROTATION OF STUDENT AFFILIATES
Description of Service: The Professional Education, Training, and Research Office (PETRO) handles and organizes clinical
rotations of medical and allied medical trainees.
OFFICE Professional Education, Training, and Research Office (PETRO)
TYPE OF
CLASSIFICATION Complex G2B – Government to Business
TRANSACTION
WHO MAY AVAIL All higher education institutions
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Letter of Intent Respective Schools
Clinical Training Program Respective Schools
Roster of participating students Respective Schools
FEES TO PROCESSING PERSON
CLIENT STEP AGENCY ACTION
BE PAID TIME RESPONSIBLE
1. Submit Letter of Intent 1.1 Receive letter and endorse None 1 hour Admin Aide VI
addressed to Medical to concerned section (PETRO)
Center Chief II thru Chief of 1.2 Send Contract of Affiliation 30 minutes Admin Assistant
PETRO to the concerned (Concerned office)
school/university
2. Review and submit signed 2.1 Receive and check contract None 15 minutes Admin Assistant
Contract of Affiliation to 2.2 Issue charge slip (Contract (Concerned office)
concerned office of Affiliation fee)
2.3 Sign Contract of Affiliation 3 days MCC II
(MCC Office)
3. Proceed to Collection and 3. Process the payment and Contract of 10 minutes Admin Officer III
Deposit Unit and provide issue official receipt Affiliation (Collection and
amount to be paid Fee: Deposit Unit)
Php1000 -
new
Php600 -
renewal
4. Return to the respective 4.1 Record and make a copy of None 10 minutes Admin Assistant
office and present the the OR (Concerned office)
official receipt 4.2 Release contract
5. Receive contract and 5. Verify list of students and None 1 day Admin Assistant
submit list of students per issue billing statement (Concerned office)
batch (Affiliation fee)
6. Proceed to Billing Unit and 6. Code billing statement and None 10 minutes Admin Officer
present the billing issue charge slip (Billing Unit)
statement
7
7. Proceed to Collection and 7. Process the payment and Affiliation fee 10 minutes Admin Officer III
Deposit Unit and provide issue official receipt per student (Collection and
amount to be paid + user’s fee Deposit Unit)
per student
8. Return to the respective 8. Record and make a copy of None 10 minutes Admin Assistant
office and present the the OR (Concerned office)
official receipt
Contract of
Affiliation
fee +
Affiliation
END OF TRANSACTION 4 days, 2 hours, and 35 minutes
fee per
student +
User's fee
per student
AFFILIATION FEE AMOUNT

Medical Students ₱3.00/ hour
Nursing Students
50 to 80 hours ₱60.00
30 to 49 hours ₱40.00
10 to 29 hours ₱30.00
1 to 9 hours ₱20.00
Psychology Students ₱2.00/ hour
Undergraduate ₱4.00/ hour
Master’s Degree ₱6.00/ hour
Doctorate Degree ₱8.00/ hour
Other Students, any discipline ₱2.00/ hour
Plus User’s Fee ₱250.00
Contracts/ Memorandum of Agreement for Affiliation
Initial signing/ new entry ₱2,000.00
Renewal of contract (2 years validity), any discipline or course ₱1,000.00
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2. APPLICATION FOR PSYCHIATRY RESIDENCY TRAINING
Description of Service: The Professional Education, Training and Research Office (PETRO) facilitates the application for the
Psychiatric Residency Training Program.
TYPE OF
CLASSIFICATION Highly Technical G2C – Government to Citizen
TRANSACTION
WHO MAY AVAIL All medical doctors
Application letter addressed to the Medical Center Chief Applicant

Curriculum Vitae of Applicant Applicant
Handwritten Autobiography Applicant
Handwritten Philosophy in Life Applicant
Original Transcript of Records (2 copies) Medical School
PSA Birth Certificate (2 original copies) Philippine Statistic Authority
NBI Clearance (2 original copies) National Bureau of Investigation
Certified True Copy of Board Rating (2 copies) Professional Regulation Commission
Certified True Copy of PRC ID (2 copies) Professional Regulation Commission
Accomplished Personal Data Sheet (2 copies) Civil Service Commission website
1. Inquire about training and 1.1 Provide information on the None 20 minutes Medical Officer III
schedule of pre-residency training program (PETRO)
through email at: 1.2 Issue checklist of
petro@ncmh.gov.ph requirements
or telephone: 02-8531-
9001 local no. 258
2. Submit documentary 2.1 Receive complete None 30 minutes Medical Officer III
requirements documentary requirements (PETRO)
and submit one (1) copy to
HRMO
2.2 Qualified applicants will be
scheduled for the pre-
residency training
3. Undergo Pre-residency 3.1 Facilitate exposure to clinical None 14 days Medical Officer III
Orientation Course experience, didactic (PETRO)
discussion, and direct
supervision
3.2 Prepare and forward Pre- 3 days
Residency Evaluation Report
to the HRMO-Selection and
Promotions Board
END OF TRANSACTION None 17 days and 50 minutes
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3. FILING AND HANDLING OF CONCERNS
Description of Service: The National Center for Mental Health (NCMH) acknowledged the importance of maintaining customer
assistance to ensure that citizens’ complaints and grievances against NCMH services, officials and employees are immediately,
efficiently, and responsibly acted upon. Operating Hours: Monday to Friday, except for holidays; 7:00 am to 4:00 pm (No Noon
Break).
OFFICE Quality Management Office
TYPE OF G2C – Government to Citizen
CLASSIFICATION Simple G2G – Government to Government
TRANSACTION
G2B – Government to Business
WHO MAY AVAIL All clients / individuals / organizations
NCMH Customer Experience Survey Form Public Assistance and Complaints Desk (PACD)
Complaint Letter Client

1. Submit/file a complaint 1.1 A. Receive and assess None 30 minutes Nurse II, IV
through the following: nature and severity of (Quality Management
Presidential Complaints complaint; Office)
Center SMS/Call: 8888
CSC Contact Center ng

Bayan SMS: 0908-8816565 1.1 B. Or, for walk-in clients at Administrative Aide VI
Call: 1-6565 Email: email@ PACD, immediately respond (PACD)
contactcenterngbayan.gov.ph to the concern or escalate to
the QMO for proper
Anti-Red Tape Authority handling.
Call: 8 478-5093 1.2 Prepare and forward the None 1 hour and 30 Nurse II, IV
Email: Transmittal Letter to the minutes (Quality Management
complaints@arta.gov.ph concerned office or Office)
individual.
NCMH-PACD Accomplish
the Customer Experience
Survey (CES) Form
2. Receive initial feedback 2.1 Conduct an investigation None 68 hours Concerned office or
and/or immediate response and provide initial feedback individual
(for clients with contact and/or immediate response
information) to the complainant if with
provided contact information.
2.2 Submit the results of None Concerned office or
investigation and actions individual
taken to the Quality
Management Office.
2.3 Prepare and submit final None 1 hour Nurse II, IV

report to the Medical Center (Quality Management
Chief for approval. Office)
10
2.4 Approve and sign the final None 30 minutes Medical Center Chief
report. (MCC Office)
3. Receive final report 3.1 Submit the final report to the None 30 minutes Nurse II, IV
client and/or concerned (Quality Management
agency where the complaint Office)
was channeled to.
3.2 Concerned agency will Concerned agency

provide a copy of the final (PCC, CSC-CCB,
report to the complainant. ARTA, DOH)
72 hours
END OF TRANSACTION None
as mandated in RA 11032
11
4. HANDLING COMPLAINT
Description of Service: The Legal Section handles and takes cognizance of administrative complaints filed by citizens and other
government agencies against the employees of the National Center for Mental Health (NCMH). Operating Hours: Monday to
Friday, except for holidays; 8:00 am to 5:00 pm (No Noon Break).
OFFICE Legal Section
TYPE OF G2G – Government to Government
CLASSIFICATION Highly Technical
TRANSACTION G2C – Government to Citizen
WHO MAY AVAIL All citizens
Written Complaint compliant with 2017 Rules on Administrative
To be provided by the client
Cases in the Civil Service (RACCS)
1. File a written complaint 1.1 Verify the correctness of the None 20 days Admin Assistant
compliant with the 2017 complaint filed in form and Legal Assistant I / II
RACCS to the Legal substance Attorney III
Section (Legal Section)
1.2 If sufficient in form and
substance, conduct a
Preliminary Investigation on
the person/s complained of
1.3 If the written Complaint is

not sufficient in form and
substance, outrightly
dismiss the Complaint
1.4 Upon finding of probable

cause, issue a Resolution
recommending Formal
Charge to be signed by the
Medical Center Chief (MCC)
1.5 Upon signature of the MCC,

transmit the case to the City
Health Office of
Mandaluyong
END OF TRANSACTION None 20 days
12
5. HANDLING OF LETTERS / CORRESPONDENCE RECEIVED THROUGH EMAIL /
COURIER / PERSONAL DELIVERIES
Description of Service: The office of the Medical Center Chief processes letters/correspondence received thru email, courier, or
personal delivery. It covers activities from receipt of letter up to sending a reply/response. Operating Hours: Monday to Friday,
except for holidays; 8:00 am to 5:00 pm (No Noon Break).
OFFICE Office of the Medical Center Chief
TRANSACTION
WHO MAY AVAIL All internal and external clients
Letter / invitations / programs (whichever is available)
Requesting individuals / office / agency
Contact details of the sender or authorized representative
1. A. Email: Send letter / 1. A. Open/Check email. None 1 day Admin Officer I
invitation / request to Acknowledge/forward/ refer (MCC Office)
official email address of to and coordinate with
NCMH, offices/persons concerned
mcc@ncmh.gov.ph or for appropriate action
B. Courier/Personal B. Check/screen/ receive

Delivery: Submit the the letter/correspondence
letter / invitation / request and forward/refer to or
to the Office of the coordinate with
Medical Center Chief offices/persons concerned
for appropriate action
2. Confirm/acknowledge 2. Provide the client with the None 1 day – urgent Admin Officer I
response to letter/ name of office, contact 2 days – non- (MCC Office)
correspondence/ email number/person and other urgent
details related to the
letter/correspondence, as
deemed necessary
2 days – urgent
3 days – non-urgent
13
6. PROVISION OF TECHNICAL ASSISTANCE ON MENTAL HEALTH PROGRAMS
Description of Service: The Office of the Special Concerns provides technical assistance ranging from provision of relevant
data/information (interview, discussion, meetings, focus group discussion, etc.) capacity-building and training (webinars, seminars,
workshops, immersion, etc.) and response (MHPSS, etc.) Operating Hours: Monday to Friday, except for holidays; 8:00 am to
5:00 pm (No Noon Break).
OFFICE Special Concerns on Mental Health
CLASSIFICATION Highly Technical G2G – Government to Government
TRANSACTION
WHO MAY AVAIL All stakeholders, individuals, national government agencies (NGAs), local government unit (LGUs),
private organizations/sectors, educational institutions (private and public), etc.
Invitation/Letter of Request Respective individual stakeholders, agencies, organizations,

etc.
1. Send an invitation/letter of 1.1 Receive invitation/letter of None 1 day Admin Officer I
request addressed to the request (MCC Office)
Medical Center Chief 1.2 Forward the letter to Office
(MCC) thru this email of the Special Concerns
address: (OSC) with a marginal note
from the MCC
NOEL V. REYES, MD, 1.3 Acknowledge and assess Medical Specialist IV
FPPA, MMHoA the request for technical (Office of Special
Medical Center Chief II assistance and endorse it to Concerns)
mcc@ncmh.gov.ph the concerned unit
2. Wait for verification/ 2.1 Coordinate and verify with None 3 days Admin Assistant II
clarification on details of the client for the details of (Office of Special
the request the request Concerns)
2.2 Evaluate the feasibility of the Nurse I /Program

request Coordinator
2.3 Prepare/formulate an action (Office of Special
plan, if feasible Concerns)
2.4 Approval of the Specific Unit Head

recommendation and action (Office of Special
plan Concerns)
3. Receive response on 3.1 Inform the client regarding None 1 day Admin Assistant II
requested assistance and the feedback (Office of Special
action plan, as applicable Concerns)
3.2 Implementation of the action Nurse I / Program

plan, as applicable Coordinator
(Office of Special
Concerns)
4. Receive and sign the 4.1 Preparation of the draft None 3 days Technical Writer
Memorandum of Memorandum of
Understanding (if Understanding (MOU), if
applicable) requiring one
4.2 Legal Section to review the 3 days Attorney III
MOU (Legal Section)
14
4.3 MOU forwarded to the 7 days Admin Assistant II
requesting agency for review Nurse I /Program
and signature Coordinator
(Office of Special
Concerns)
4.4 MOU forwarded to MCC for 3 days Medical Center Chief

approval II
(MCC Office)
4.5 Notarization of MOU 1 day Admin Assistant II

Nurse I /Program
Coordinator
(Office of Special
Concerns)
5. Receive the approved 5. Finalize Training Design, None 3 days Specific Unit Head
request program flow, activities, and (Office of Special
content-related materials Concerns)
6. Conduct of the technical 6.1 Provide the technical None 1 day Specific Unit Head
assistance assistance (or as indicated (Office of Special
6.2 Facilitate the post activity in the design) Concerns)
evaluation survey
15
7. REQUEST FOR APPROVAL OF A SYSTEM FOR HANDLING
PERSONAL INFORMATION
Description of Service: The Data Privacy Act seeks to guarantee fundamental human rights to privacy and communication while
also ensuring the free flow of information in order to foster innovation and growth. The service is one method of safeguarding your
privacy. Operating Hours: Monday to Friday; 7:00 am to 4:00 pm (No Noon Break)
OFFICE Quality Management Office (QMO)
CLASSIFICATION Complex G2G – Government to Government
TRANSACTION
WHO MAY AVAIL All clients / individuals / organization
Manual of Operation (Soft copy) Requesting Party
Transmittal letter Requesting Party
1. Email manual of operation 1.1 Receive request None 5 minutes Data Protection
of the system to be Officer
implemented (either for 1.2 Review and evaluate the None 6 days (Quality Management
pilot testing or full submitted protocol and Office)
implementation) and procedure documents, as
transmittal letter to well as the transmittal letter
dpo@ncmh.gov.ph
1.3 Approve or disapprove the None 1 hour

request.
If disapproved, the
requesting party will be
informed of the reason for
the denial
2. Receive the requested 2. Release the approved None 5 minutes Data Protection
document/s document Officer
(Quality Management
Office)
END OF TRANSACTION None 6 days, 1 hour and 10 minutes
16
8. REQUEST FOR DATA COLLECTION
Description of Service: Provides data and information for researchers who intend to study related to mental health.

TYPE OF
CLASSIFICATION Simple G2C – Government to Citizen
TRANSACTION
WHO MAY AVAIL All external clients
Letter of Request Requesting Individual
Charge Slip/ Billing Statement PETRO or Program Coordinator of concerned office
Official Receipt Collection and Deposit Unit
FEES TO PROCESSI PERSON
BE PAID NG TIME RESPONSIBLE
1. Submit letter of intent 1.1 Receive letter and forward to Chief None 2 days Administrative Aide VI
addressed to Medical PETRO for approval (PETRO)
Center Chief II thru 1.2 If approved: Endorse to concerned
Chief PETRO office
If disapproved: Inform client the
reason of disapproval
2. Proceed to concerned 2. Issue charge slip/ payment None 10 minutes Program Coordinator
office for issuance of (concerned office)
charge slip/ billing
statement
3. Proceed to Collection 3. Process the payment and issue Refer to 10 minutes Administrative Officer
and Deposit Unit and official receipt schedule of III (Collection and
provide amount to be fees below Deposit Unit)
paid
4. Return to concerned 4.1 Record official receipt and release None 10 minutes Administrative
office and present data based on the approved Assistant
official receipt request (Concerned office)
4.2 Instruct to undergo the Technical
Review (refer to Citizen’s Charter
on Research/ Thesis Technical
Review), if applicable
Refer to
END OF TRANSACTION schedule of 2 days and 30 minutes
fees below
PARTICULARS AMOUNT
1. Clinical Trials Per Contract
2. Post Graduate (Masters / Doctorate: Non-Employee (Non-Affiliate and Affiliate)
i. Research Office ₱2,000.00
ii. Institutional Fee ₱2,400.00
iii. If involved the use of patient(s) ₱100.00 per patient
3. College Students (any discipline)
i. Research Office ₱200.00
ii. Institutional Fee ₱200.00
iii. If involved the use of patient(s) ₱100.00 per patient
4. State Universities FREE
17
9. REQUEST FOR FOI INFORMATION
Description of Service: Freedom of Information (FOI) allows Filipino citizens to request any information about government
transactions and operations, provided that it shall not put into jeopardy privacy and matters of national security. Operating Hours:
Monday to Friday, except for holidays; 7:00 am to 4:00 pm (No Noon Break).
OFFICE Quality Management Office
TRANSACTION
WHO MAY AVAIL All clients / individuals / organizations
Request Form (Online) FOI Website (www.foi.gov.ph)
Transmittal Letter Quality Management Office
1. Log-in to www.foi.gov.ph 1.1 Receive and transmit the None 1 hour DOH-KMITS
and follow the instructions request to the concerned
agency
1.2 Receive and assess nature None 2 hours Nurse I

of request, and transmit to (QMO)
the concerned office or
individual along with a
Transmittal Letter
1.3 Prepare the requested None 11 days Concerned individual
documents for submission to or office
the QMO for proper
transmittal
1.4 Verify completeness of the None 2 hours Nurse I
requested documents, (QMO)
conformity to the existing
laws and recommends for
the approval of the MCC
1.5 Approve the final report None 2 days Medical Center Chief
II
(MCC Office)
2. Receive the requested 2.1 Transmit the requested None 1 hour Nurse I
document/s documents to DOH-KMITS (QMO)
2.2 Issue the documents to the None 1 hour DOH-KMITS

requesting party
18
10. REQUEST FOR INCIDENTAL CRISIS AND STRUCTURED EMERGENCY RESPONSE
Description of Service: The NCMH Disaster Risk Reduction Management in Health (DRRM-H) Unit supports Administrative Order
No. 2019-0046 “National Policy on DRRM-H” as an integrated systems-based, multi-sectoral process that utilizes policies, plans,
programs, and strategies that provides timely, effective, and efficient response to unexpected occurrence and activities that needs
its preparedness, assistance, and mitigation.
OFFICE Disaster Risk Reduction and Management in Health Unit
Simple – Incidental
Crisis TYPE OF G2C – Government to Citizen
CLASSIFICATION
Complex – Structured TRANSACTION G2G – Government to Government
Emergency
Letter of Request / Call for response Requesting office or agency
1. Request for Response 1.1 Check email, open and None Incidental Crisis - Nurse II / V
thru: acknowledge or confirm 1 hour upon Medical Specialist I
request from the requesting acknowledgement (DRRM-H Office)
A. Email: office/agency of request.
Received letter/request to correspondence/email/letter
official email address of 1.2 Receive call/notice and Structured
NCMH DRRM-H Unit at acknowledge or confirm Emergency –
drrmh@ncmh.gov.ph request thru verbal call or 3 days upon
mobile text message acknowledgement
B. Courier/Personal 1.3 Selection of personnel of request.
Delivery based on acquired training/s
Received letter/request to applicable for response:
the DRRM-H Manager. - BLS
- ACLS
C. Call: - SFA
From DOH Operation - EMT
Center to Mental base; 1.4 Request for Hospital Order
NCMH local phone unit (HO)
(loc. 228); DRRM-H
Manager mobile unit
2. Coordination of response 2.1 Acquire list of provision/s None Incidental Crisis – Admin Aide I/ VI
provisions & situational needed for response 7 hours Nursing Attendant II
report 2.2 If with provision of: Nurse I/ II/ V
A. Accommodation Structured Medical Officer IV
B. Food Emergency – Medical Specialist I
C. Medicines 4 working days (DRRM-H Office)
D. Transportation;
project request for Incidental
Expenses needed for
response from funding
agency
2.3 If without provision of
Accommodation and
Food: Request for Cash
Advance from sending
agency (NCMH)
19
2.3.1 Medicines: Request
needed supplies from
pharmacy of sending
agency (NCMH)
2.3.2 Transportation: Request
and acquire trip ticket thru
NCMH Transport Service
2.4 Prepare needed documents,
supplies and equipment
needed for response/
deployment
2.5 Pre deployment meeting
3. Receive Response 3.1 Organize and deploy None Varies from Admin Aide I, VI,
Deployment of Health medical teams to respond to requested Nursing Attendant II,
Emergency Response emergency medical needs response duration Nurse I, II, V,
Team (HERT) 3.2 Ensure the availability of Medical Officer IV,
medical teams with Medical Specialist I
ambulance/s (DRRM-H Office)
3.3 Coordinate with requesting
agency.
Incidental Crisis:
Urgent – 1 hour
Not Urgent – 8 hours
Structured Emergency:
7 working days
20
11. REQUEST FOR TECHNICAL ASSISTANCE ON MENTAL
HEALTH AND DOH PROGRAMS
Description of Service: The Public Health Unit provides technical assistance related to the promotion of mental health, as well as
DOH programs. Operating Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm (No Noon Break).
OFFICE Public Health Unit
TRANSACTION
WHO MAY AVAIL All individuals, agencies, and organizations needing technical assistance related to the promotion
of mental health, as well as DOH programs
Invitation/Request Letter Respective individuals/agencies/organizations
1. Send an invitation/request 1.1 Receive invitation/request None 3 days Admin Officer I
letter addressed to the letter (MCC Office)
Medical Center Chief 1.2 Forward the letter to PHU
(MCC). The letter may be with a marginal note from the
sent thru this email MCC
address:
mcc@ncmh.gov.ph;
cc: phu@ncmh.gov.ph
2. Wait for verification/ 2.1 Coordinate and verify with None 3 days Admin Assistant II
clarification of details of the the client for the details of Admin Aide IV
request the request (PHU)
2.2 Evaluate the feasibility of the Nurse I / II

request (PHU)
2.3 Prepare/formulate an action Nurse I / II

plan, if feasible (PHU)
2.4 Approval of the Nurse II / HEPO III

recommendation and action (PHU)
plan
3. Receive response on 3.1 Inform the client regarding None 1 day Admin Assistant II
requested assistance and the feedback Admin Aide IV
action plan, as applicable (PHU)
3.2 Implementation of the action Nurse I / II

plan, as applicable (PHU)
21
12. REQUEST FOR TRAINING ASSISTANCE
(BASIC LIFE SUPPORT AND STANDARD FIRST AID)
Description of Service: The Department of Health – Health Emergency Management Bureau (DOH-HEMB) being the lead in
capacity building for emergencies and disasters provides various capability development activities including the conduct of Basic
Life Support and Standard First Aid Training for all health workers. Operating Hours: Monday to Friday, except for holidays; 8:00
am to 5:00 pm (No Noon Break).
OFFICE Disaster Risk Reduction and Management in Health Unit
TRANSACTION G2G – Government to Government
WHO MAY AVAIL NCMH Employees, any government offices (local or national)
Letter of Request addressed to DRRM-H Manager Requesting client
Final list of participants with their respective email addresses Requesting client
1. Submit to DRRM-H the 1. Receive and check None 10 minutes Administrative Aide I
request for training completeness of Nurse I
requirements (DRRM-H Office)
2. Initial submission of list of 2.1 Check for availability of None 3 days Nurse II
participants together with schedule Medical Specialist I
their respective emails 2.2 Send Notice of Training to (DRRM-H Office)
the letter’s signatory (either
via email or courier) with
indicated date and time of
training
3. Submit final list of 3. Check for the completeness None 3 days Nurse II
participants of requirements Medical Specialist I
a. Final names of (DRRM-H Office)
participants
b. Email of final list of
participants
No changes shall be made
after this step
4. Receive Notice of 4. Send Notice of Confirmed None 3 days Nurse II
Confirmation thru email or Training schedule Medical Specialist I
courier (DRRM-H Office)
5. Receive training 5. Conduct training None 2 days – BLS Nursing Attendant II

Nurse I/ II/ V
4 days – Medical Specialist I
Standard First Medical Officer IV
Aid (DRRM-H Office)
11 days and 10 minutes – BLS Training

END OF TRANSACTION None 13 days and 10 minutes – Standard
First Aid Training
22
13. RESEARCH/THESIS TECHNICAL REVIEW
Description of Service: The Professional Education, Training and Research Office (PETRO) facilitates the technical review of
researches associated with the institution.
Letter of Endorsement PETRO
Manuscript (7) hardcopies and soft copy Client
1. Submit Letter of 1.1 Check validity and None 1 day Admin Officer II
endorsement signed by completeness of (TRC Secretariat)
adviser and manuscript to requirements
PETRO 1.2 Forward to the Technical
email soft copy to: Review Committee
petro@ncmh.gov.ph 1.3 Schedule defense
2. On the day of schedule, 2. Evaluation of the merit of None 1 hour and 15 Technical Review
present proposal to the research proposal minutes Committee
panel If pass: proceed to step 4
If pass with minor

revisions:
Submit revised manuscript
with summary of changes
then proceed to step 3
If pass with major

revisions:
Submit revised manuscript
with summary of changes
then return to step 2
If fail: Submit new

manuscript and return to
step 1
3. Submit revised manuscript 3.1 Check documents (summary None 10 minutes Admin Officer II
of changes and manuscript - (TRC Secretariat)
7 hard copies and soft copy
sent to email)
3.2 Route summary of changes 3 days Technical Review
to concerned TRC Committee
member/s for further
checking and signature
If approve: proceed to step
4
If disapprove: resubmit
manuscript with to include
necessary change/s
23
4. Wait for the approval of 4.1 Prepare approval form and None 10 minutes Admin Officer II
clearance route to TRC members (TRC Secretariat)
4.2 Affix signature 2 days Technical Review

Committee
5. Receive approval clearance 5. Release clearance None 10 minutes Admin Officer II

to be submitted to (TRC Secretariat)
Research Ethics
Committee
END OF TRANSACTION None 6 days, 1 hour, and 45 minutes
24
14. ADMISSION PROCESS FOR NON-PSYCHIATRIC PATIENTS
Description of Service: The service is offered to all non-psychiatric clients with medical/surgical condition requiring admission at
Pavilion 7 Ward 4. Operating Hours: The service is available 24/7.
OFFICE Pavilion 7 E.R
CLASSIFICATION Simple
WHO MAY AVAIL All non-psychiatric clients
Admitting Order Consultant
Negative RAT or RTPCR Result Client’s testing laboratory of choice
1. From Pavilion 7 Emergency 1. Issue Admitting Order and None 1 hour Consultant
Room, secure Admitting Sociological Data Sheet Medical Officer III / IV
Order Medical Specialist III
(Pavilion 7 E.R)
2. Accomplish Sociological 2. Facilitate creation of None 25 minutes Admin Assistant II / III
Data Sheet and submit to admission documents and (HIMS)
HIMS with the admitting slip signing of treatment consent
form
3. Proceed to Philhealth Unit 3. Verify client’s record if they None 25 minutes Admin Aide I – IV
for verification of record are eligible for Philhealth (Claims Unit)
enrollment and provide
PMRF and CF2
4. Return to Pavilion 7 and 4.1 Orient client of ward rules, None 15 minutes Nurse I / II
sign the Informed Consent policies, and set-up (Pavilion 7 E.R)
and Waiver for Admission 4.2 Notify the receiving ward
NOD
5. Proceed to ward 5.1 Transfer and endorse None 20 minutes Nurse I / II

patient to ward (Pavilion 2 E.R)
5.2 Receive patient and conduct 15 minutes
head-to-toe assessment Nurse I / II
5.3 Assist patient into ward (Pavilion 7 Ward 4)
END OF TRANSACTION None 2 hours and 40 minutes
25
15. ADMISSION TO PSYCHIATRIC WARD
Description of Service: This process is for psychiatric patients that need hospital admission. Operating Hours: The service is
available 24/7.
OFFICE Pavilion 2 Psychiatric Emergency Section
TYPE OF
TRANSACTION
WHO MAY AVAIL All psychiatric clients requiring admission
Admitting Order (1) original copy Admitting Physician (ER)
Valid government issued ID (1) original copy Respective issuing government agencies
Official Receipt (for paying service users) Collection and Deposit Unit
1. Secure Physician Admitting 1. Issue Admitting Order None 2 minutes Medical Officer III/ IV
Order Sheet from Pavilion 2 (Pavilion 2 ER)
E.R
2. Proceed to Philhealth unit 2. Verify client’s record if they None 25 minutes Admin Aide I - VI
for verification of record are eligible for Philhealth (Claims Unit)
enrollment and provide
(Please see Request for PMRF and CF2
Philhealth benefit Eligibility
Form Process) For non-Philhealth
member: Facilitate
enrollment to Philhealth
3. Service Users: Service Users: None 24 minutes Social Welfare Officer
Proceed to the Medical 3.1 Conduct Interview and I/ II
Social Service Office for classify client accordingly; (Medical Social
classification and proceed and Service Section)
to step no. 6 3.2 forward documents to HIMS
Paying Service Users: Paying Service Users: None 5 minutes Admin Aide I/ III
Proceed to the Billing Unit 3.1 Provide information and Admin Assistant I/ II/
(Temporarily suspended) explain hospital guidelines III
for admission; and Admin Officer I
3.2 Issue Charge Slip (Billing Unit)
4. Paying Service Users: 4. Receive payment and issue Please see 10 minutes Administrative Officer
Proceed to Collection and official receipt below III (Collection and
Deposit Unit and pay Deposit Unit)
required amount
5. Proceed to HIMS for 5. Conduct orientation and None 5 minutes Admin Aide I/ III
signing of contract and facilitate signing of Admin Assistant I/ II
other necessary documents documents (HIMS)
26
6. Return to Pavilion 2 E.R for 6. Assist client for admission to None 5 minutes Nurse I/ II
admission Pavilion 2 PAU or Pavilion 7 for Nursing Attendant I/ II
medical intervention (Pavilion 2 ER)
Refer to
56 minutes – Service Users
END OF TRANSACTION schedule of
52 minutes – Paying Service User’s
fees below
RATE FOR ADMISSION AMOUNT

Paying Service User
A. Private Room ₱1,000/day
i. Initial payment (2 months) ₱60,000.00
ii. Medicine initial payment ₱5,000.00
iii. Doctor’s fee (Psychiatrist only) ₱10,000 (maximum rate)
B. Semi-Private Room ₱800/day
C. Ward ₱600/day
Service User None
Note: Admission for paying service user is temporarily suspended
27
16. ADMISSION/TRANS-IN PROCESS FOR PSYCHIATRIC PATIENTS
Description of Service: The service is offered to all psychiatric clients exhibiting Covid 19 related symptoms on top of their acute
or chronic medical condition that requires proper holistic care and comprehensive patient-centered management. Operating
Hours: The service is available 24/7.
TYPE OF
TRANSACTION
WHO MAY AVAIL All patients from Pavilion 2 ER/OPS and in-patients
Admitting Order (1) original copy Admitting Physician
If client is from Pavilion 2 ER/OPS: Consent for Admission
Pavilion 2 ER/OPS
signed by relative or Social Worker
1. Proceed to Pavilion 7 E.R 1. Verify client’s record None 5 minutes Nurse I / II
with chart and admitting (Pavilion 7 E.R)
order
2. For clients from Pavilion 2. For admission: Facilitate None 5 minutes Nurse I / II
2 ER/OPS: Sign consent signing of consent and (Pavilion 7 E.R)
and waiver for admission waiver
For trans-in: Accomplish
Report of Illness (ROI)
3. Undergo physical 3.1 Conduct physical None 20 minutes Nurse I / II

assessment assessment and history Medical Officer III / IV
taking (Pavilion 7 E.R)
3.2 Carry out doctor’s order
3.3 Notify the respective
receiving ward
4. Proceed to ward 4.1 Transfer and endorse None 20 minutes Nurse I / II

patient to ward (Pavilion 2 E.R)
4.2 Receive patient and conduct
head-to-toe assessment None 15 minutes Nurse I / II
4.3 Assist patient into ward (Pavilion 7 Ward 4)
END OF TRANSACTION None 1 hour and 5 minutes
28
17. CONSULTATION OF PRESUMPTIVE TB CASE
Description of Service: The TB DOTS Clinic is a DOTS providing facility that renders consultation, TB counselling, and HIV
screening and counselling. The TB DOTS Clinic ensures availability of quality-assured Genexpert, HIV test, and sputum smear
microscopy as well as uninterrupted supply of anti-TB medications, supervised treatment, and health teaching. Operating Hours:
Monday to Friday, 8:00 am to 5:00 pm (No Noon Break).
OFFICE Pavilion 7 - TB DOTS Clinic
TYPE OF
TRANSACTION
WHO MAY AVAIL All OPD and in-patients
For In-Patient:
Patient Chart Pavilion of origin
Chest X-ray result NCMH Clinical Laboratory
Intra-Hospital Referral form (1) original copy Pavilion of origin
For OPD Client:
Referral Form (1) original copy Private Clinic/Doctor
Patient Chart Health Information Management Section (HIMS)
Chest X-ray result Clinical Laboratory
GeneXpert Result (if applicable) Clinical Laboratory
1. For In-Patient: Submit 1.1 For In-Patient: Receive and None 25 minutes Nurse I / II
patient’s chart, chest X-ray evaluate patient’s chart, Medical Officer IV
result and intra-hospital chest x-ray and intra-hospital (TB DOTS Clinic)
referral form to TB DOTS referral form
Clinic 1.2 Issue GeneXpert request
form
For OPD Client: Proceed For OPD Client: None 25 minutes Nurse I / II
to TB DOTS Clinic and 1.1 Receive and evaluate chest Medical Officer IV
submit chest x-ray result or x-ray and GeneXpert result (TB DOTS Clinic)
GeneXpert result (if 1.2 Issue Sociological data
applicable) and fill-out the sheet
Sociological data sheet
2. For In-Patient: Collect 2.1 For In-Patient: Receive None 5 minutes Nurse I / II
sputum specimen and sputum specimen for (TB DOTS Clinic)
submit to TB DOTS Clinic GeneXpert and submit to
Clinical Laboratory Section
for testing
2.2 Process the specimen None 1 day Med Tech II / III
(Clinical Laboratory
Section)
For OPD Client: Proceed For OPD Client: None 20 minutes Admin Aide I
to HIMS and submit Encode, print, and issue (HIMS)
Sociological data sheet Sociological data sheet to
the client
29
3. For In-Patient: Receive 3.1 For In-Patient: None 1 day Nurse I / II
treatment plan If GeneXpert (+) – Trans- Medical Officer IV
out client to TB Pavilion for (TB DOTS Clinic)
treatment
If GeneXpert (-) – issue

clearance and conduct
health teaching
If for PTB treatment with

COVID: Start TB medication
at the Pavilion of origin then
for trans-out to TB pavilion
once with negative RT- PCR
as ordered
For OPD Client: Return to 3.1 For OPD Client: Receive None 5 minutes Nurse I / II
TB DOTS Clinic, submit sputum specimen for (TB DOTS Clinic)
patient’s chart and sputum GeneXpert and submit to
specimen Clinical Laboratory Section
for testing
3.2 Process the specimen None 1 day Med Tech II / III
Section)
4. For OPD Client: Receive 4. For OPD Client: None 1 day Nurse I / II
treatment plan If GeneXpert (+) – start TB Medical Officer IV
treatment (TB DOTS Clinic)
If GeneXpert (-) – issue

clearance and conduct
health teaching
2 days and 30 minutes

In-Patient
2 days and 50 minutes
OPD Client
30
18. DENTAL CONSULTATION AND MANAGEMENT
Description of Service: The Dental Section provides dental consultation and oral treatment and management. Operating Hours:
Monday to Friday, 8:00 am – 5:00 pm.
OFFICE Dental Section
For In-patient:
Patient’s Chart Pavilion of origin
Doctor’s Referral Pavilion of origin
Philhealth (for POS) Claims Unit
Consent of relative (1) original copy
For Out-patient:
Patient’s record Health Information Management Section
For Walk in client:
PBEF (if applicable) Claims Unit
FOR IN-PATIENT WITH PHILHEALTH

1.1 The Nursing Attendant 1.1 Conduct oral examination None 2 hours and 30 Dentist
brings the patient to the 1.2 Issue Charge Slip minutes (Dental Section)
Dental Clinic for 1.3 Conduct oral treatment and
assessment management with consent
1.2 Submit the patient chart from relatives or PIC
with doctor’s referral (Physician-in-charge) or
COP (Chief of Pavilion)
2. The Nursing Attendant 2. Process Philhealth request None 25 minutes Admin Aide I - VI
proceeds to Claims Unit (Claims Unit)
to process patient’s
Philhealth
(Refer to Request for

Philhealth Benefit
Eligibility process)
3. Return to Dental Section. 3.1 Receive and check None 30 minutes Admin Aide
Submit Philhealth Philhealth requirements
requirements and assist 3.2 Issue prescription Dentist
patient back to ward (Dental Section)
31
FOR IN-PATIENT WITHOUT PHILHEALTH

1.1 The Nursing Attendant 1.1 Conduct oral examination None 2 hours and 30 Dentist
brings the patient to the 1.2 Issue charge slip and minutes (Dental Section)
Dental Clinic for Malasakit Dental
assessment Assessment Form
1.2 submit the patient’s chart 1.3 Conduct oral treatment and
with doctor’s referral management
2. The Nursing Attendant 2. Process medical assistance None 2 hours and 15 Chief, Medical Social
proceeds to Malasakit request minutes Service Section and
Center Malasakit Center
Operations Manager
(Refer to Malasakit Center (Malasakit Center)
Request for Medical
Assistance process)
3. Return to Dental Section. 3.1 Receive and check None 30 minutes Admin Aide
Submit Malasakit Malasakit requirements
requirements and assist 3.1 Issue prescription Dentist
patient back to ward (Dental Section)
FOR OUT-PATIENT AVAILING MALASAKIT MEDICAL ASSISTANCE

1. Secure referral from 1. Process the request and None 30 minutes Admin Aide I
Physician-in-charge. issue patient record (HIMS)
Proceed to HIMS and
request for the patient’s
record (Refer to Request
for Access to Health
Records process)
2. Proceed to Dental Section 2.1 Conduct oral examination None 30 minutes Dentist
for oral examination 2.2 Issue charge slip and (Dental Section)
Malasakit Assessment
Request Form
3. Proceed to Malasakit 3. Process medical assistance None 2 hours and 15 Chief, Medical Social
Center (Refer to Malasakit request minutes Service Section and
Center Request for Medical Malasakit Center
Assistance process) Operations Manager
(Malasakit Center)
4. Return to Dental Section 4.1 Receive and check None 2 hours and 30 Admin Aide
and submit Malasakit Malasakit requirements minutes
requirements and undergo 4.2 Conduct oral treatment and Dentist
oral treatment and management (Dental Section)
management 4.3 Issue Prescription
32
FOR WALK-IN CLIENT WITH PHILHEALTH

1. Proceed to Dental Clinic 1. Conduct oral examination None 30 minutes Dentist
for oral examination (Dental Section)
2. Proceed to Claims Unit to 2. Process Philhealth request None 25 minutes Admin Aide I - VI
process Philhealth (Refer (Claims Unit)
to Request for Philhealth
Benefit Eligibility process)
3. Proceed to HIMS and 3. Issue patient record None 30 minutes Admin Aide I
request for the patient (HIMS)
record (refer to Request
Records process)
4. Return to Dental Section 4.1 Receive and check None 2 hours and 30 Admin Aide
and submit Philhealth Philhealth requirements minutes
requirements and 4.2 Conduct oral treatment and Dentist
undergo oral treatment management (Dental Section)
and management 4.3 Issue prescription and
charge slip
FOR PAYING WALK-IN CLIENT

1. Proceed to Dental Clinic for 1.1 Conduct oral examination None 30 minutes Dentist
oral examination 1.2 Issue charge slip (Dental Section)
2. Proceed to HIMS and 2. Process the request and None 30 minutes Admin Aide I
request for the patient issue patient record (HIMS)
record (Refer to Request
Records process)
3. Proceed to Collection and 3. Process the payment and Refer to 10 minutes Administrative Officer
Deposit Unit and provide issue Official Receipt schedule of III (Collection and
amount to be paid fees below Deposit Unit)
33
4. Return to Dental Section 4.1 Receive and check OR None 2 hours and 30 Admin Aide
and present official receipt 4.2 Conduct oral treatment and minutes
and undergo oral treatment management Dentist
and management 4.3 Issue prescription (Dental Section)
Refer to
END OF TRANSACTION schedule of 3 hours and 40 minutes
fees below
LIST OF FEES FOR DENTAL SERVICES

PROCEDURE PRICE
Oral Examination ₱235.00
Oral Prophylaxis ₱660.00
Tooth Restoration ₱537.00
Tooth Restoration (Deep Seated Caries) ₱1087.00
Tooth Extractions ₱518.00
Temporary Filling ₱357.00
Gum Treatment ₱329.00
Surgery: (Odontectomy’Alveoloplasty/Gingivoplasty/Alveolectomy/Gingivoplasty) ₱4529.00
Operculectomy ₱1629.00
34
19. DISCHARGE PROCESS FOR PSYCHIATRIC PATIENT
Description of Service: When a patient is medically and surgically stable and able to go home or transfer to another type of facility
for continuity of care and management.
OFFICE Pavilion 7 (FMI / MMI / Surgery)
TYPE OF
TRANSACTION
WHO MAY AVAIL All patients admitted at Pavilion 7 who are medically and surgically stable and no longer requiring
in-patient care
Doctor’s Order Doctor
Discharge Clearance Pavilion 7 Nurse Station
Philhealth Form (if applicable) Philhealth Office/Nurse Station
Valid I.D of relative or Social Worker (1) original copy Any government or private agencies
Authorization Letter (relative) To be provided by the client
Birth certificate (1) photocopy Philippine Statistics Authority
1. Receive Notice of 1.1. Order Discharge Planning None 30 minutes Consultant
Discharge
1.2. Contact relatives regarding 1 hour and 30 Medical Social Worker
the discharge date and minutes (Medical Social
requirements needed prior Service)
to discharge
1.3. Accomplish Social Workers
notes and submit to nurse
on duty within the day
1.4. Document order of 30 minutes Medical Officer III
discharge (Pavilion 7 ward)
1.5. Accomplish Philhealth forms
2. Proceed to Pavilion 7 2.1 Verify documents for None 30 mins Medical Social Worker
Social Service and present relative’s identification (MSSS)
required documents
2.2 Provide discharge clearance Nurse I / II
(Pavilion 7 Ward)
3. Proceed to respective 3. Verify client’s account, once None 1 hour Pharmacist
offices for signing of cleared, sign the discharge (Pharmacy Section)
clearance clearance
Radiologist
(Radiology Section)
Med Tech
(Laboratory Section
Nursing Attendant
(CSR)
Admin Officer
(Philhealth)
Medical Social Officer
(Malasakit Center)
35
4. Proceed to Billing Section 4. Issue final statement of None 10 minutes Admin Officer
account (Billing Unit)
5. Return to Pavilion 7 and 5.1 Verify and check the official None 10 minutes Nurse I / II
present signed discharge receipt and discharge (Pavilion 7 Ward)
clearance and discharge clearance
slip/ or HAMA 5.2 Provide discharge
instructions, health
education, prescription (if
applicable) and follow-up or
referral slips
5.3 Assist the patient and
relatives for discharge
36
20. DISPENSING OF MEDICAL SUPPLIES
Description of Service: The Central Supply Room services provide for the requested hospital medical supplies utilizing
standardized recording, reporting, and monitoring of hospital stocks. Operating Hours: The service is available 24/7.
OFFICE Central Supply Room
TYPE OF
TRANSACTION
WHO MAY AVAIL All in-patients
Requisition and Issuance Slip (RIS) CSR Office
1. Submit Requisition and 1.1 Receive and check RIS None 5 minutes Nursing Attendant I / II
Issuance Slip (RIS) 1.2 Check availability of (CSR)
requested supplies
2. Wait for the supply 2. Prepare the available None 10 minutes Nursing Attendant I / II
requested supplies (CSR)
3. Receive requested supplies 3. Dispense the requested None 5 minutes Nursing Attendant I / II
and sign on the RIS supplies (CSR)
For paying and Philhealth

enrolled service users:
Encode charges to patient’s
hospital bill to HOMIS
system
END OF TRANSACTION None 20 minutes
37
PRICELIST OF MEDICAL SUPPLIES
ITEM / DESCRIPTION UNIT OF MEASURE SRP

Personal Protective Equipment Set A (Full): ₱298.00
Personal Protective Equipment Set B (Gown): ₱195.00
3-WAY Stopcock piece ₱43.00
Alcohol Isopropyl, 70% gallon ₱218.00
Alcohol Isopropyl, 70%, 500mL bottle ₱31.00
Alcohol Isopropyl, 70%, 100mL bottle ₱6.00
Alcohol Prep Pad 2x2 piece ₱2.00
Anesthesia Mask, ADULT piece ₱376.00
Anesthesia Set Flex, w/ fitting mask, Adult piece ₱478.00
Anesthesia Set Flex, w/ fitting mask, Pedia piece ₱478.00
Antiseptic Surgical Scrub Solution 50ml bottle ₱11.00
Anti Embolism Thigh High Stocking ₱1,950.00
Arterial Blood Gas Test Calibrant piece ₱47.50
Arterial Blood Gas Test Cartridge BG3 piece ₱409.62
Bacterial / Viral Filter for breathing circuit piece ₱175.50
Bed pan, plastic piece ₱69.00
Blood Glucose Test Strip w/ Lancet piece ₱5.00
Blood Transfusion Set piece ₱18.00
BMC Breathing Circuit pc ₱5,200.00
Bottle Chest Thoracostomy Set set ₱559.00
Bouffant Cap piece ₱1.00
Cast, Fiberglass Casting piece ₱433.00
Cast, Undercast/Wadding Sheet/Orthopedic Padding 4"x5m piece ₱32.00
Cautery Pad piece ₱357.50
Electro Cautery Pencil piece ₱322.00
Cautery Tip Long 15cm, ball piece ₱1,040.00
Cautery Tip Long 15cm, needle type piece ₱1,040.00
Cautery Tip Short 15cm, ball piece ₱494.00
Cautery Tip Short 15cm, needle type piece ₱455.00
Chemical Indicator Strip piece ₱16.00
Chest Tube/Drainage Thoracic Catheter, fr.28 piece ₱442.00
Chest Tube/Drainage Thoracic Catheter, fr.29 piece ₱442.00
Chlorhexidine Swabs piece ₱5.00
Chromic Cutting 1-0 piece ₱33.00
38
Chromic round 0 piece ₱338.00
Chromic round 1-0 piece ₱299.00
Chromic round 2-0 piece ₱307.00
Chromic Round 3-0 piece ₱106.00
Chromic Round 4-0 piece ₱347.00
Cigarette Drain, size 1 piece ₱58.50
Cigarette Drain, size 1/2 piece ₱58.50
Cigarette Drain, size 1/4 piece ₱58.50
Closed System Suction Catheter (fr.14) piece ₱403.00
Colostomy Bag with Wafer, 57mm piece ₱295.00
Colostomy Bag with Wafer, 60-70mm piece ₱253.50
Condom piece ₱9.00
Cotton Absorbent Balls pack ₱5.00
Cotton Applicator piece ₱1.00
Coverall Suit, 2xl-3xl set ₱160.00
Diaper, Large piece ₱20.00
ECG Electrodes, Adult, Disposable piece ₱8.00
ECG Electrodes, Pedia, Disposable piece ₱21.00
Elastic Bandage 4inches x 5yards piece ₱19.00
Elastic Bandage 6inches x 5yards piece ₱24.00
Endotracheal tube size 6.5 piece ₱26.00
Extension Tubing piece ₱52.00
Faceshield piece ₱8.00
Flexible Adult Tracheostomy Tube size 6.0 piece ₱4,368.00
Foley Catheter, fr.8 piece ₱31.00
Foley Catheter, fr.8 (All Silicon) piece ₱156.00
39
Foley Catheter, fr.16 (3-way) piece ₱64.00
Foley Catheter, fr. 22 (3-way) piece ₱143.00
Foley Catheter, fr. 24 (3-way) piece ₱162.50
Gauze Bolt, Surgical bolt ₱797.00
Gauze, surgical sterile, 4x4 pack ₱26.00
Gloves, Examination, Latex, Large piece ₱3.00
Gloves, Examination, Latex, Medium piece ₱3.00
Gloves, Examination, Latex, Small piece ₱3.00
Gloves, sterile size 6.0 pair ₱15.00
Guedel Airway size 1 piece ₱23.00
Heparin Cap luer lock set ₱13.00
High Flow Nasal Cannula (Medium) piece ₱1,143.00
Household Water Purification Tablets, 67mg piece ₱9.00
Hydrogen Peroxide 3% Antiseptic Solution, 250mL bottle ₱97.00
IJ Insertion Kit, Arrow Brand) (w/ other med supplies) set ₱3,855.00
Industrial Salt sack ₱1,062.00
Infusion Set, Adult piece ₱11.00
Infusion Set, Pedia piece ₱11.00
IV Cannula g.18 piece ₱78.00
KN95 Mask piece ₱7.00
Laparatomy Sponge 8x36 piece ₱198.00
Lubricating Jelly 80grams tube ₱109.00
40
Lubricating Jelly, 5grams Piece ₱4.00
Manual Resuscitator, Adult set ₱908.50
Mask, Surgical piece ₱2.00
Mechanical Ventilator / Breathing Circuit piece ₱650.00
Medical Intubation Stylet Guide Wire, fr.12 piece ₱520.00
Medical Intubation Stylet Guide Wire, fr.10 piece ₱65.00
Medical Oxygen Portable Refill, 15lbs. cylinder ₱450.00
Medical Oxygen Standard size, Refill cylinder ₱450.00
Medical Oxygen Consumption 1L liter ₱11.25
Mucus Specimen Extractor piece ₱66.00
N95 Mask piece ₱108.00
Nasal Oxygen Cannula, Adult piece ₱13.00
Nasal Oxygen Cannula, Pedia piece ₱13.00
Nasogastric Tube, fr.5 piece ₱10.00
Nebulizing Kit, Adult piece ₱88.00
Nebulizing Kit, Pedia piece ₱65.00
Needle G.18, 20, 22 piece ₱1.00
Needle G.26, 27, 30 piece ₱2.00
Needle butterfly scalp vein g.21 piece ₱16.00
Non-Rebreathing mask with safety valve piece ₱218.00
Nylon cutting 3-0 piece ₱429.00
Nylon cutting 5-0 P.3 piece ₱429.00
Nylon cutting 6-0 P.3 piece ₱429.00
Nylon cutting 6-0 PS2 Needle piece ₱429.00
Nylon cutting 10-0, Opthalmic Needle piece ₱747.50
Ortho Gloves, size 7.0 pair ₱70.00
Orthoplast Skin Traction Kit set ₱715.00
41
Oxygen Regulator set ₱940.00
Oxygen Mask, Adult piece ₱25.00
Oxygen Mask, Adult piece ₱30.00
PGA / Polyglactic acid cutting 0 piece ₱520.00
PGA / Polyglactic acid cutting 1-0 piece ₱390.00
PGA (Polyglycolic acid) cutting 2-0 piece ₱455.00
PGA/Polylactic acid size cutting 3-0 piece ₱390.00
PGA/Polylactic acid size cutting 4-0 piece ₱127.00
PGA/ Polyglactin cutting 5-0 P3 piece ₱585.00
PGA/Polylactic acid size round 0 (75cm) piece ₱127.00
PGA/Polylactic acid size round 0 (90cm) piece ₱127.00
PGA/Polylactic acid size round 1-0 piece ₱127.00
PGA /Polyglactin acid size round 4-0 piece ₱624.00
PGA (Polyglactin) round 8-0 piece ₱662.00
Polypropylene knitted non-absorbable mesh piece ₱1,885.00
Polypropylene monofilament cutting 0 piece ₱116.00
Polypropylene monofilament cutting 2-0 piece ₱390.00
Polypropylene monofilament round 1-0 piece ₱325.00
Polypropylene monofilament round 0 piece ₱351.00
Polypropylene suture round needle 6-0, BV-1 piece ₱521.00
Povidone Iodine 10%, 100ml bottle ₱35.00
Povidone Iodine Prep Pads piece ₱3.00
Pulse Oximeter piece ₱585.00
Sharp Disposable Container, 30 liters piece ₱1,092.00
Razor Blade piece ₱28.00
Shoe Cover pair ₱3.00
Silk Strand 0 piece ₱260.00
Silk Strand 1-0 piece ₱260.00
42
Silk Cutting 0 piece ₱182.00
Silk Cutting 1-0 piece ₱143.00
Silk cutting 2-0 piece ₱234.00
Silk round 0 piece ₱247.00
Silk round 1-0 piece ₱143.00
Skin Stapler Wire piece ₱344.50
Sodium Hypochlorite, bleaching agent gallon ₱243.00
Spinal Needle g.21 piece ₱156.00
Spinal Needle g.23 ₱83.00
Spinal Needle g.25 piece ₱78.00
Spinal Needle g.26 ₱83.00
Sterile Water, 1L bottle ₱143.00
Sterile Water, 100ml bottle ₱166.40
Steri Strip 12mm x 100mm piece ₱156.00
Steri Strip 6mm x 100mm piece ₱585.00
Sterile Gauze Pads 2x2 (Individually pack) pack ₱99.00
Sterile Gauze Pads 4x4 (Individually pack) piece ₱3.00
Stockinette Bandage per yard yard ₱49.00
Straight Catheter, fr.8 piece ₱18.00
Suction Catheter, fr.16 piece ₱5.00
Suction Poole Drain piece ₱235.00
Surgical Blade #10 piece ₱3.00
43
Surgical Blade #20 with Handle piece ₱64.00
Surgical Scrub/Brush piece ₱54.00
Surgical Gown piece ₱57.00
Surgical Marking Pen piece ₱373.10
Surgical Micropore Tape 1" roll ₱58.00
Syringe, Asepto piece ₱23.00
Syringe, Heparinized Syringe piece ₱93.60
Syringe 1cc (Tuberculin) piece ₱2.00
Syringe 1cc (Insulin) piece ₱3.00
Syringe 3cc with needle g.23 piece ₱2.00
Syringe, disposable, 10cc piece ₱3.00
T-Tube, size 14 piece ₱169.00
Thermometer, Digital piece ₱43.00
Thermometer, Infrared piece ₱547.00
Tongue Depressor piece ₱1.00
Tourniquet piece ₱19.50
Tracheostomy Mask, Adult piece ₱364.00
Transparent Film w/ absorbent pad (10cmx15cm) piece ₱117.00
Transparent Film with absorbent pad (9cmx15cm) piece ₱130.00
Transparent Film dressing without gauze 4x4 piece ₱82.00
Transpore Plaster 1 inch spool ₱84.00
Underpads piece ₱11.00
Urinal, Plastic piece ₱37.00
Urine Bag piece ₱11.00
Volumetric Incentive Spirometer, 1200cc piece ₱389.00
Volumetric Solution Set (Soluset) piece ₱41.00
Warming Blanket, Adult (Bear Hugger) piece ₱1,560.00
44
Wound Drainage 100-150mL (Jackson Prat) piece ₱1,274.00
Wound Drainage 400mL (Jackson Prat) piece ₱845.00
Zinc Oxide Adhesive Plaster 1 inch roll ₱563.00
Zinc Oxide Adhesive Plaster 2 inches roll ₱708.00
Zinc Oxide Adhesive Plaster 3inches roll ₱325.00
Zinc Oxide Adhesive Plaster 3inches roll ₱156.00
Cherries / Peanut Gauze piece ₱5.00
Dressing A ₱25.00
Dressing B ₱60.00
Dressing C ₱120.00
Epidural Kit with Spinal Needle kit ₱240.00
IFC Kit kit ₱155.00
Injection Kit kit ₱18.00
IV Insertion Kit kit ₱169.25
New Born Kit kit ₱180.00
OR Gauze pack, 4x4 pack ₱50.00
OR Gauze pack, 4x8 piece ₱100.00
SAB Kit (Spinal Anesthesia) kit ₱156.00
Skin Preparation kit without Brush kit ₱127.00
Skin Preparation Kit kit ₱209.00
Straight Catheter Kit kit ₱82.00
Visceral Pack pack ₱100.00
All prices are subject to change without prior notice
45
21. EMERGENCY CARE AND MANAGEMENT FOR NON-PSYCHIATRIC PATIENTS
Description of Service: The pavilion 7 Emergency Room caters to non-psychiatric patients (NCMH employees, employees’
dependents and non-NCMH employees/dependents) seeking urgent care and management. Operating Hours: The service is
available 24/7.
WHO MAY AVAIL All non-psychiatric patients (NCMH Employees, their dependents and outsiders) seeking urgent
care and management
Health Declaration form Triage Area Main gate
1. Proceed to Pavilion 7 ER 1.1 Check Health Declaration None 2 hours Nursing Attendant I / II
and present Health form Nurse I / II
Declaration form 1.2 Conduct initial assessment Medical Officer III / IV
and provide immediate Medical Specialist I / II
medical intervention / III
(Pavilion 7 E.R)
For Non-NCMH employee:
Issue Sociological Data
Sheet and ER form
For NCMH employee:

Instruct client to proceed to
Pavilion 7 HIMS for patient’s
chart.
1.3 Disposition
a. Admission
b. Discharge
c. HAMA – Secure HAMA
form and waiver signed
by the patient
d. THOC – Issue referral
letter to client and
secure waiver
2. If for admission: (Refer 2. If for Admission: Process None 2 hours and 40 Nurse I / II
to Admission Process for Admission minutes (Pavilion 7 E.R)
Non-Psychiatric Patient) If for discharge: Issue
charge slip
If for discharge: Assess for eligibility of Chief, Medical Social

A. Client may proceed to endowment 2 hours and 15 Service Section and
Malasakit Center for minutes Malasakit Center
medical assistance Operations Manager
(For diagnostic exams (Malasakit Center)
and medications only)
(Refer to Malasakit
Center Medical
Assistance Procedure)
46
B. Paying Service User: Process payment and issue Php500.00 + 10 minutes Admin Officer III
Proceed to Collection official receipt Diagnostic (Collection and
and Deposit Unit and fee + Deposit Unit)
settle the bill Hospital
supplies
used
3. Return to Pavilion 7 E.R 3.1 Verify official receipt None 15 minutes Nursing Attendant I / II
and present official 3.2 provide health education, Nurse I / II
receipt give prescriptions, and (Pavilion 7 E.R)
schedule for follow-up
3.3 Assist for discharge
Refer to
Refer to Total Processing Time Table
below
fees below
CLIENT CATEGORY AMOUNT

NCMH Employee FREE
₱500.00 (ER fee) + Diagnostic fee + hospital
Paying Service User
supplies used = Total amount to be paid
TOTAL PROCESSING TIME PROCESS

2 hours E.R Process
4 hours and 40 minutes E.R Process with Admission
4 hours 30 minutes E.R Process with Discharge (Malasakit)
2 hours and 25 minutes E.R Process with Discharge (paying service user)
47
22. EMERGENCY CARE AND MANAGEMENT FOR PSYCHIATRIC PATIENTS
Description of Service: The pavilion 7 Emergency room caters to psychiatric patients from other pavilions seeking urgent care
and management. Operating Hours: The service is available 24/7.
TYPE OF
TRANSACTION
WHO MAY AVAIL All psychiatric patients from other pavilions seeking urgent medical care and management
Patient’s Chart Pavilion of Origin
1. Proceed to Pavilion 7 E.R 1.1 Conduct triaging and initial None 15 minutes Nursing Attendant I / II
with the NAOD and assessment Nurse I / II
patient’s chart 1.2 Provide rapid treatment and Medical Officer III / IV
intervention if necessary Medical Specialist I / II
/ III
(Pavilion 7 E.R)
2. Undergo medical 2.1 Conduct history taking, None 30 minutes Nurse I / II
intervention and applicable examinations and Medical Officer III / IV
management and required provide appropriate Medical Specialist I / II
diagnostic procedures management / III
2.2 Refer client accordingly for (Pavilion 7 E.R)
co-management
2.3 Evaluate results and prepare
disposition
Accomplish Report of Illness
(ROI)
3 If for admission: (refer to 3. Process admission None 1 hour and 5 Nurse I / II
Admission Process for minutes Medical Officer III / IV
Psychiatric Patients) Medical Specialist I / II
/ III
If for Trans-out: Receive Issue prescription and 5 minutes (Pavilion 7 E.R)
prescription and laboratory laboratory request (if
request and return back to applicable) and assist client
pavilion of origin for discharge
below
45 minutes E.R Process
50 minutes E.R Process with Trans-out (back to pavilion of origin)
1 hour and 50 minutes E.R Process with Admission
48
23. FORENSIC PSYCHIATRY CONSULTATION
Description of Service: This service is offered to all clients with pending court cases, requiring psychiatric consultation.
OFFICE Forensic Psychiatry Section
TYPE OF
TRANSACTION
WHO MAY AVAIL Clients 19 years old and above with court case/s
Court Order (2) original or photocopy Trial Court
Case Information (2) original or photocopy Philippine National Police
Referral Letter (if applicable) Referring agency (CSWD, Barangay, PNP, etc.) and/or
attending physician
1. Secure schedule thru 1.1 Check Court Order None 5 minutes Medical Officer III/ IV
a. Phone 85319001 loc. 320 1.2 Check if client has Medical Specialist III
b. E-mail at symptoms of COVID-19 (Pavilion 4)
ncmhforensic@gmail.com 1.3 Provide schedule date for
consultation
2. On the day of consultation, 2.1 Check temperature None 5 minutes Medical Officer III
proceed to Triage area for 2.2 Accomplish history and Nurse I
COVID-19 screening symptoms checklist Midwife
(Triage Area)
3. Proceed to the Health 3.1 Secure patient record/chart None 30 minutes Administrative Aide I
Information Management 3.2 Call Forensic Psychiatry (HIMS)
Section (HIMS) Section to get the patient's
record
4. Proceed to Pavilion 4, wait 4.1 Conduct interview, history None 1 hour Medical Officer III/ IV
to be called, and submit taking, mental status Medical Specialist III
self for evaluation and/or examination, physical and (Pavilion 4)
management neurologic exam
4.2 Provide prescription (if
necessary)
4.3 Schedule of psychological
exam (if necessary)
4.4 Provide follow-up instruction
and slip
49
24. HEMODIALYSIS TREATMENT FOR IN-PATIENTS
Description of Service: Hemodialysis Treatment rendered on an in-patient basis covers admitted psychiatric and non-psychiatric
service users who are prescribed by the Nephrologist to undergo the foresaid procedure. It takes place through consistent
collaboration with allied health care team members to cater patients diagnosed with either acute or chronic kidney disease.
Operating Hours: Monday to Saturday, 7:00 am-8:00 pm; 24/7 for emergency cases.
OFFICE Hemodialysis Clinic
WHO MAY AVAIL All in-patients (psychiatric and non-psychiatric)
Psychiatric Clearance for psychiatric patients National Center for Mental Health - Psychiatrist
Hemodialysis Prescription from Nephrologist on Duty Pavilion of Origin
Signed Consent for Hemodialysis Pavilion of Origin
Laboratory/ Radiological Tests Results Within the Month (1
original or photocopy) inclusive of:
• CBC with Platelet Count
• Blood Typing
• BUN/ Creatinine
• Calcium, Sodium, Potassium Any Diagnostic laboratory or NCMH Laboratory/
• Albumin, Phosphorus, BUA, SGPT NCMH Radiology
• Chest X-ray (within 7 days)
• RTPCR (within 7 days)
• HBSAg, Anti-HBS, Anti-HCV
HIV, RPR/TPPA (Syphilis) NCMH Laboratory Section

1. Once consent for 1.1 Receive and check for None 15 minutes Nurse I/ II
hemodialysis, hemodialysis completeness of pre- (Dialysis Clinic)
prescription and hemodialysis requirements
hemodialysis access are 1.2 Refer to NCMH
secured, Nurse-on-duty Laboratory/Radiology for
from pavilion of origin will necessary pending result/s
inform via phone call the
Hemodialysis Clinic to
acquire the patient’s
treatment schedule
2 Proceed to Hemodialysis 2.1 Perform extensive checking None 25 minutes Nurse I / II
Clinic of hemodialysis (Dialysis Clinic)
requirements attached to
patient’s chart
2.2 Secure Hemodialysis Medical Officer III / IV
mechanics to Nephrologist Medical Specialist I / II
on Duty Nephrologist on Duty
2.3 Carry out dialysis (Dialysis Clinic)
prescription ordered
3. Receive hemodialysis 3.1 Perform pre-hemodialysis None 6 hours Nurse I / II
treatment assessment to patient Medical Officer III / IV
3.2 Initiate hemodialysis Medical Specialist I / II
treatment as ordered by Nephrologist on Duty
Physician (Dialysis Clinic)
50
4. Return to pavilion of origin 4.1 Terminate hemodialysis None 20 minutes Nurse I / II
treatment and conduct post- (Dialysis Clinic)
dialysis assessment
4.2 Endorse the patient to
Nurse-on-duty from patient’s
pavilion of origin
END OF TRANSACTION None 7 hours
51
25. HEMODIALYSIS TREATMENT FOR OUT-PATIENTS
Description of Service: Hemodialysis Treatments provided on an out-patient basis requires the clients/relatives to comply with
the procedure of gaining a slot for treatment in the unit. The treatment usually lasts for four (4) hours but may extend or shorten
depending on the physician’s and/or nurse’s assessment, and the patient is discharged subsequently. Philhealth-related
requirements may be required for coverage of treatments. Operating Hours: Monday to Saturday 7:00 am - 8:00 pm.
OFFICE Hemodialysis Clinic
WHO MAY AVAIL NCMH Employees; Mandaluyong Residents; DOH and other Government Agencies Referrals;
Class C/D (Psychiatric or Non Psychiatric Patients)
Endorsement Letter from Nephrologist (1) original copy Previous Dialysis Center/ Hospital Hemodialysis Unit
Clinical Abstract with Hemodialysis Prescription (1) original
Previous Dialysis Center/ Hospital Hemodialysis Unit
copy
Treatment Sheet of Last 3 Sessions
(1) photocopy for each treatment Previous Dialysis Center/ Hospital Hemodialysis Unit
Guarantee Letter covering HD Treatments/ Medication/
Government agencies issuing guarantee letters
Laboratory Tests (1) original copy
Endorsement Letter for Mandaluyong residents only (1) original
Office of the Congressman
copy
Approved Letter from Medical Center Chief Office of the Medical Center Chief (NCMH)
Laboratory/ Radiological Tests Results Within the Month (1)
original or photocopy, inclusive of:
• CBC with Platelet Count
• Blood Typing
• BUN/ Creatinine
• Calcium, Sodium, Potassium Any Diagnostic laboratory or NCMH Laboratory/
NCMH Radiology
• Albumin, Phosphorus, BUA, SGPT
• Chest X-ray (within 7 days)
• RTPCR (within 7 days)
• HBSAg, Anti-HBS, Anti-HCV
HIV, RPR/TPPA (Syphilis) NCMH Laboratory Section
Covid-19 Vaccination Record Local Government Unit or Recognized Private Health Care
Provider
Dialysis Center Utilization Certification (1) original copy Previous Dialysis Center/ Hospital Hemodialysis Unit
Philhealth Utilization Certificate (1) photocopy Main Philhealth Office
Updated Members Data Record (1) photocopy Main Philhealth Office
Philhealth Identification Card (1) photocopy Main Philhealth Office
Barangay Certificate of Indigency / Social Case Study
(1) photocopy Local Government Unit
Senior Citizen (SC) or Persons with Disability (PWD) ID (1) Respective Municipal/City Hall
(Person with Disability Affair Office /
photocopy
Office of the Senior Citizen Affair)
Voter’s ID or Voter’s Certification COMELEC Office on Respective Municipal/City Hall
52
1. Proceed to Dialysis Clinic 1.1 Receive and check for None 15 minutes Nurse I / II
with complete requirements completeness, and answer (Dialysis Clinic)
for evaluation any queries
1.2 Refer to NCMH Laboratory
for necessary laboratory
tests
2. Proceed to the Health 2. Retrieve hemodialysis chart None 5 minutes Admin Aide I / III
Information Management of patient (HIMS)
Section
3. Proceed to Medical Social 3.1 Interview client/ relative and None 15 minutes Social Worker
Service Section for accomplish MSWD (MSS Section)
qualification Assessment Tool for new
patients
3.2 Make referral letter for Social Welfare Officer
medical assistance as I
needed (MSS Section)
3.3 Review guarantee letters for
treatments not covered by
Philhealth
4. For Philhealth Client: 4.1 Collate Philhealth-related None 15 minutes Admin Aide I – IV
Proceed to Philhealth requirements and issue a Admin Officer III
Office for qualification certification (Claims Unit)
4.2 If exhausted Philhealth-
covered treatments, no
certification will be issued
5. Return to the Dialysis Clinic 5. Check vital signs, conduct None 30 minutes Nurse I / II
for Pre-Hemodialysis interview and physical Medical Officer III / IV
Assessment and examination Medical Specialist I / II
scheduling of treatment (Dialysis Clinic)
6. Return on scheduled 6.1 Collect the certification None 4 hours 30 Nurse I / II
treatment and submit issued by the Philhealth minutes (Dialysis Clinic)
Philhealth Certification officer
6.2 For exhausted Philhealth
coverage, secure guarantee
letter notated by the Social
Worker
6.3 Initiate hemodialysis Nurse I / II
treatment Medical Officer III / IV
Medical Specialist I / II
(Dialysis Clinic)
7 Preparation for discharge 7. Terminate hemodialysis None 20 minutes Nurse I / II

session and conduct post (Dialysis Clinic)
dialysis assessment
53
26. OPD CONSULTATION FOR IN-PATIENTS
Description of Service: The Out Patient Department caters all psychiatric in-patients seeking non-emergent cases. Operating
Hours: Monday- Friday, except for holidays; 8:00 am - 5:00 pm (No Noon Break).
OFFICE Pavilion 7 Out Patient Department
TYPE OF
TRANSACTION
WHO MAY AVAIL All psychiatric in-patients
Laboratory Result (if applicable) Laboratory Section
1. Nurse on duty from 1.1 Verify the information given None 5 minutes Nurse I / II
Pavilion of origin shall 1.2 Provide schedule of Medical Officer III / IV
inform the OPD Physician consultation Medical Specialist I / II
on duty at local 361 / III
regarding the nature of (Pavilion 7 OPD)
referral
2. On the time of schedule, 2.1 Conduct initial assessment None 30 minutes Nurse I / II
the patient, accompanied 2.2 Conduct consultation and Medical Officer III / IV
by the Nursing Attendant on provide intervention and Medical Specialist I / II
duty will proceed to Pavilion management / III
7 OPD for consultation 2.3 Issue prescription and (Pavilion 7 OPD)
diagnostic request, if
applicable
2.4 Provide schedule of follow
up and referral, if applicable
54
27. OPD CONSULTATION FOR OUT-PATIENTS AND NCMH EMPLOYEES
Description of Service: The OPD caters to all out-patients, NCMH employees, and their qualified dependents seeking OPD
consultation/check-up. Operating Hours: Monday to Friday, except for holidays; 8:00 am - 5:00 pm (No Noon Break).
OFFICE Pavilion 7 Out Patient Department / Employee’s Clinic
WHO MAY AVAIL All non-psychiatric out-patients, NCMH employees and their dependents
Health Declaration Form Triage Main Gate
Laboratory Result (if applicable) Laboratory Section / Radiology Section
Patient’s Chart Health Information Management Section (HIMS)
1. Proceed to Pavilion 7 OPD 1. Check health declaration None 5 minutes Nurse I / II
and present Health form and instruct client to (Pavilion 7 OPD)
Declaration form proceed to pavilion 7HIMS
2. Old client: Proceed to 2. Old client: Verify client’s None 15 minutes Admin Aide/ Admin
HIMS at Pavilion 7 and name and issue patient’s Assistant
request for patient’s chart chart (HIMS Pavilion 7)
New client: Proceed to
HIMS at pavilion 7 and New client: encode
accomplish Sociological sociological data information
Data Sheet
3. Return to Pavilion 7 OPD, 3.1 Conduct initial assessment None 30 minutes Nurse I / II
submit patient’s chart, and 3.2 Conduct consultation and Medical Officer III / IV
undergo consultation/ provide intervention and Medical Specialist I / II
check-up management / III
3.3 Issue charge slip (Pavilion 7 employees
Waiting time: 1 hour Clinic/ OPD)
4. Proceed to Collection and 4. Process the payment and Refer to 10 minutes Admin Officer I
Deposit Unit issue official receipt schedule of (Collection and
fees below Deposit Unit)
5. Return to Pavilion 7 OPD 5.1 Verify OR None 10 minutes Nurse I / II
and present OR 5.2 Issue prescription, and Medical Officer III / IV
diagnostic request (if Medical Specialist I / II
applicable), / III
5.3 Provide schedule of follow (Pavilion 7 employees
up and referral (if applicable) Clinic/ OPD)
and conduct health teaching
Refer to
END OF TRANSACTION table of 1 hour and 10 minutes
fees below
PATIENT CATEGORY AMOUNT
NCMH Employee None

₱300.00 (OPD fee) + hospital supplies used +
Out-Patient Consultation fee of attending Medical Specialist =
Amount to be paid
55
28. OPERATING ROOM PROCEDURE FOR IN-PATIENTS
Description of Service: The Operating Room Department provides Operating procedures (elective cases) to all in-patients.
OFFICE Pavilion 7 O.R Department
TYPE OF
TRANSACTION
Negative RT-PCR / RAT Laboratory Section
Notification Slip Pavilion of Origin
Pre-Operative Checklist Pavilion of Origin
Informed Consent Pavilion of Origin
1. For Scheduled Operation: 1.1 Receive patient None 10 minutes Nurse I / II
Proceed to Pavilion 7 OR 1.2 Check completeness of Midwife II
requirements Nursing Attendant II
(Pavilion 7 OR)
2. Undergo operation 2. Perform operation None 3hours – minor MO IV

procedure operation MS I / II / III
Nurse I / II
12 hours – Midwife II
major operation Nursing Attendant II
or depending on (Pavilion 7 OR)
the case
3. Transfer to Recovery Room 3. Monitor patient until stable None 2 hours Nurse I / II
Midwife II
Nursing Attendant II
(Pavilion 7 OR)
4. Trans-out to pavilion of 4.1 Inform NOD of pavilion of None 30 minutes Nurse I / II

origin origin Midwife II
4.2 Conduct endorsement Nursing Attendant II
(Pavilion 7 OR)
If paying service user:
Issue charge slip and
forward to CSR and
Pharmacy for encoding
5 hours and 40 minutes – Minor

Operation
14 hours and 40 minutes – Major
Operation
56
29. PSYCHIATRIC EMERGENCY CARE AND MANAGEMENT
Description of Service: The Psychiatric Emergency Section caters all clients seeking urgent psychiatric care and management.
Operating Hours: Operating Hours: The service offered is available 24/7.
OFFICE Pavilion 2 Psychiatric Emergency Section
TYPE OF
TRANSACTION
WHO MAY AVAIL All clients requiring urgent psychiatric care and management
COVID-19 Vaccination Card (if applicable) VAXCertPH
1. Proceed to Pavilion 2 1.1 Conduct triaging, vital signs None 5 minutes Nurse I / II
Psychiatric Emergency taking and initial (Psychiatric E.R)
Room assessment
1.2 Provide rapid treatment and 10 minutes Medical Officer III

intervention if necessary (Psychiatric E.R)
2. Accomplish Sociological 2. Encodes data and issue None 5 minutes Nurse I / II

Data Sheet Patient’s chart (Psychiatric E.R)
3. Undergoes medical 3.1 Conduct history taking, None 3 hours 15 Medical Officer III / IV
intervention and applicable examination and minutes Nurse I / II
management and subject to provide appropriate Nursing Attendant I, II
required diagnostic management (Psychiatric E.R)
procedures
3.2 Refer client accordingly for Medical Officer III/ IV
co-management Nurse I / II
(Psychiatric E.R)
3.3 Evaluate results and
prepare disposition
4 If for Admission: (Refer to 4. If for Admission: Process None 56 minutes – Nurse I / II
Admission to Psychiatric Admission Service Users (Psychiatric E.R)
Ward Procedure)
52 minutes –
Paying Service
Users
If for discharge: (Refer to If for Discharge: Assess for 2 hours and 15 Chief, Medical Social
Malasakit Center Medical eligibility of endowment, if minutes – Service Section and
Assistance Procedure) or not eligible issue charge slip Malasakit Malasakit Center
receive charge slip if not Assistance Operations Manager
eligible for endowment (Malasakit Center)
57
5. Proceed to Collection and 5. Process the payment and issue ₱500.00 – 10 minutes Admin Officer III
Deposit Unit and provide Official receipt ER Fee (Collection and
amount to be paid Deposit Unit)
6. Return to the Emergency 6.1 Conduct health education None 5 minutes Nurse I, II
Room and present Official 6.2 Issue prescription, out- (Psychiatric E.R)
Receipt patient referral slip and
laboratory request if
applicable.
6.3 Assist client for admission /
discharge
END OF TRANSACTION ₱ 500.00
below
3 hours and 40 minutes E.R Process
5 hours and 55 minutes E.R Process with Discharge (Malasakit Center)
3 hours and 50 minutes E.R Process with Discharge (Paying Service User)
4 hours and 36 minutes E.R Process with Admission (Service User)
4 hours and 32 minutes E.R Process with Admission (Paying Service User)
58
30. PSYCHIATRIC OUT-PATIENT CONSULTATION
Description of Service: The Outpatient Section caters all clients (Child, Adult, Geria, and Neuro) seeking non-emergent psychiatric
management. Operating Hours: Monday to Friday, except for Thursday and holidays; 8:00 am – 5:00 pm (No Noon Break).
OFFICE Pavilion 2 - Out-Patient Section
TYPE OF
TRANSACTION
WHO MAY AVAIL All clients requiring non-emergent psychiatric care and management
For first consultation: Valid I.D (1) original copy Any government agencies / Private companies
For follow-up consultation:
OPD card OPD Section
Schedule slip OPD Section
Certificate of Indigency Barangay
Additional Requirements for Child and Adolescent clients:
Request Letter, if applicable
Court Order (1) photocopy, if applicable To be provided by the client
Social Case Study Report (1) photocopy, if applicable
Referral Letter (1) photocopy, if applicable
1. Fill out the Health 1. Check the Health None 1 minute Nurse I / II
Declaration form at NCMH Declaration form and (Triage Area)
main gate temperature
2. Proceed to OPS Triage and 2.1 Categorize patient as None 1 minute Nursing Attendant I
present patient’s hospital follows: (Pavilion 2 OPS
I.D a. Child Triage)
b. Adult
c. Geria
d. Neuro
e. New/Old client
2.2 Issue two (2) copies of
queuing number
3. Receive queuing number 3. First consultation: Encode None 30 minutes Admin Aide I
and proceed to Pavilion 2 the Sociological Data (HIMS)
HIMS Information and conduct
photo capturing
First consultation:
Proceed to HIMS (Window For follow-up
3) submit 1 copy of the consultation: Verify data for
queuing number and fill out chart retrieval
the Sociological Data Sheet
Follow-up consultation:
Proceed to HIMS (Window
2) and submit 1 copy of the
queuing number
(Scheduled patients only)
59
4. Proceed to the Vital signs 4. Check vital signs None 5 minutes Nurse I
area (Pavilion 2 OPS)
5. Proceed to the Consultation 5.1 Conduct consultation and None Refer to total Medical Officer
area provide intervention and processing time (Pavilion 2
management table below Consultation Area)
5.2 Issue prescription, schedule
of follow-up and referral for
injection (if applicable)
5.3 Prepare medical
certificate/abstract (if
applicable)
6. Proceed to Malasakit 6. Verify documents and None 2 hours and 15 Chief, Medical Social
Center for medical assess for eligibility of minutes Service Section and
assistance. Present the endowment Malasakit Center
following: Operations Manager
a. Prescription (Malasakit Center)
b. Diagnostic
requests
c. Certificate of
Indigency
d. Valid I.D
(Refer to Malasakit Center
Medical Assistance
procedure)
7. Proceed to the Pharmacy 7. Verify prescription and None 5 minutes Pharmacist I / II
Section and present the release the medicine (Pharmacy Section)
approved prescription and
receive the medicine
Return on the scheduled

date for diagnostic exams,
if applicable
below
TOTAL PROCESSING TIME

CATEGORY
FIRST CONSULTATION FOLLOW-UP CONSULTATION
Child and Adolescent 3 hours and 57 minutes 3 hours and 27 minutes
Adult 3 hours and 27 minutes 3 hours and 7 minutes
Geria 4 hours and 27 minutes 3 hours and 57 minutes
Neuro 3 hours and 57 minutes 3 hours and 27 minutes
Note: Medical Certificate / Clinical Abstract will only be issued to clients who had at least three (3) consecutive check-ups
and one (1) psychological test
▪ Referral / Assessment for Child Adoption cases is not accepted.
▪ No personal copy of psychological report will be issued to the relative.
▪ A Court Order, request letter from DSWD, School (signed by guidance councilor and/or principal), Attending
Physician and other Agency, stating the purpose of use is needed for the release of psychological report.
▪ Adult, Geria, and Neuro Section does not cater Court Cases, Annulment, Adoption and Custody, and
Naturalization
60
31. PSYCHIATRIC OUT-PATIENT ONLINE CONSULTATION
Description of Service: The Psychiatric Online Consultation caters all adult and aged care service users seeking non-emergent
psychiatric management. Operating Hours: Monday to Friday, except for Thursday and holidays; 8:00 am – 5:00 pm (No Noon
Break).
WHO MAY AVAIL All clients requiring non-emergent psychiatric care and management
Valid ID (scanned copy) Respective issuing agencies
1.1 Search in the browser 1.1 Receive data None 20 minutes Admin Assistant
bit.ly/ncmhkonsulta and fill 1.2 Verify and forward the (Pavilion 2 OPS)
out the following: information to the Health
a. booking form Information Management
b. informed consent Section (HIMS)
c. basic information 1.3 Encode / load chart to EMR 15 minutes Admin Aide III
d. medical and (HIMS)
psychosocial history
1.2 Upload valid I.D
2. Wait for the confirmation 2. Send confirmation and other None 5 minutes Admin Assistant
via e-mail and/or text details for the free online (Pavilion 2 OPS)
message session via doxy.me one (1)
day upon receipt
3. On the day of e- 3.1 Conduct initial interview, None 30 minutes – Medical Officer III / IV
consultation, follow the history taking and mental Adult (Pavilion 2 OPS)
instruction given to log in to status examination
doxy.me and submit to 3.2 Provide e-prescription (if 1 hour - Geria
initial interview necessary) and reference
slip
1 hour and 10 – Adult online
consultation
1 hour and 40 minutes – Aged care
online consultation
61
32. REQUEST FOR REFILL OF MEDICATIONS (ROM)
Description of Service: The service is available from Monday to Friday, except Thursday and holidays, 8:00 am – 5:00 pm (No
Noon Break)
TYPE OF
TRANSACTION
WHO MAY AVAIL All clients enrolled in Refill of Medication
Hospital I.D card Out-Patient Section
Schedule Slip for ROM OPS
1. Fill out the Health 1. Check the Health None 1 minute Nurse I / II
Declaration form at NCMH Declaration form and (Triage Area)
main gate temperature
2. Proceed to OPS Triage and 2. Issue ROM form and None 5 minutes Nursing Attendant
present patient’s hospital queuing number Nurse I
I.D and fill out ROM form (Pavilion 2 OPS
Triage)
3. Submit ROM form (OPS 3. Receive and check for the None 5 minutes Nursing Attendant
Triage) completeness of data Nurse I
(Pavilion 2 OPS
Triage)
4. Proceed to HIMS submit 4. Forward patient’s record to None 15 minutes Admin Aide I
queuing number and OPS thru EMR (HIMS)
Hospital I.D
5. Proceed to waiting area to 5. Review patient’s record and None 5 minutes Medical Officer III / IV
receive refill prescription issue prescription (OPS)
6. Proceed to Malasakit 6. Verify documents and None 2 hours and 15 Chief, Medical Social
Center for Medical assess for eligibility of minutes Service Section and
Assistance endowment Malasakit Center
Operations Manager
(Refer to Malasakit Center
(Malasakit Center)
Medical Assistance
procedure)
7. Proceed to the Pharmacy 7. Verify prescription and None 5 minutes Pharmacist I / II
Section and present the release the medicine (Pharmacy Section)
approved prescription and
receive the medicine
62
33. WCPU FOLLOW-UP CONSULTATION
Description of Service: The Women and Children Protection Unit aims to:
1. Identify all women and children who are victims of abuse under the following: RA 9262, RA 7610, RA 7877, RA 8353, RA
8505, RA 9208, and RA 11313 Safe Spaces Act.
2. Evaluate, diagnose and initiate treatment for all identified women and children who are victims of abuse
3. Provide proper documentation of all identified cases of women and children abuse
4. Report all cases seen of women and children abuse to appropriate agencies
Operating Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm (No Noon Break)
OFFICE Pavilion 15 – Women and Children Protection Unit
TYPE OF
TRANSACTION
WHO MAY AVAIL Women and Children under RA 9262, RA 7610, RA 7877, RA 8353, RA 8505, RA 9208, AND RA
11313 Safe Spaces Act
Schedule Slip WCPU
Reference Slip WCPU
1. Proceed to WCPU and 1. Verify schedule and provide None 1 minute Midwife II, Nurse I
present schedule slip queuing number (WCPU)
2. Wait for your name/number 2.1 Conduct psychiatric None 1 hour 30 Medical Officer III
to be called for interview, interview, examination and minutes Medical Specialist IV
examination and treatment treatment (WCPU)
necessary)
2.3 Provide follow-up schedule Midwife II, Nurse I
slip and reference slip (WCPU)
3. If for Psychological 3. Conduct Psychological None 4 hours Psychologist

Assessment: Proceed to Assessment (Psychological
Psychological Assessment Psychological Section)
room and present schedule report will be
slip released after
18 working days
(Refer to Psychological
Assessment for Out-
Patient)
63
34. WCPU INITIAL CONSULTATION
Description of Service: The Women and Children Protection Unit aims to:
1. Identify all women and children who are victims of abuse under the following: RA 9262, RA 7610, RA 7877, RA 8353, RA
8505, RA 9208, and RA 11313 Safe Spaces Act.
2. Evaluate, diagnose and initiate treatment for all identified women and children who are victims of abuse
3. Provide proper documentation of all identified cases of women and children abuse
4. Report all cases seen of women and children abuse to appropriate agencies
Operating Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm (No Noon Break)
OFFICE Pavilion 15 – Women and Children Protection Unit
TYPE OF
TRANSACTION
WHO MAY AVAIL Women and Children under RA 9262, RA 7610, RA 7877, RA 8353, RA 8505, RA 9208, AND RA
11313 Safe Spaces Act
Referral Letter (1) original copy (if applicable) Referring agency (PNP, CSWD, LGU/Barangay, PAO,
Lawyer), Attending Physician
Social Case Study Report (1) original Copy (if applicable) DSWD
Court Order/ Subpoena or any pertinent documents to the case
Trial Court
if applicable (1) photo copy (if applicable)
Police Report or Barangay Blotter (if applicable) Philippine National Police / Barangay Office
Marital or Relationship History (for VAWC cases only) (if
Service User
applicable)
1. Proceed to WCPU for 1.1 Receive and verify None 5 minutes Midwife II, Nurse I
triaging and submit presented documents if (WCPU)
necessary documents available
1.2 Issue schedule slip
2. Proceed to Health 2. Encode and issue patient None 20 minutes Administrative Aide I
Information Management record (HIMS)
Section for patient record
3. Return to WCPU and sign 3.1 Assist client in signing the None 5 minutes Midwife II, Nurse I
the Informed consent Informed Consent (WCPU)
3.2 Conduct initial assessment 20 minutes Medical Officer III
and classification Medical Specialist IV
(WCPU)
4. Submit self for appropriate 4.1 Conduct psychiatric None 1 hour 30 Medical Officer III
evaluation and treatment interview and provide minutes Medical Specialist IV
treatment (WCPU)
4.2 Refer to Psychological
Section for psychological
assessment
necessary)
4.4 Provide follow-up schedule Midwife II, Nurse I
slip and reference slip (WCPU)
64
35. ACCESSING HEALTH CARE INFORMATION OF IN-PATIENT AND OUT-PATIENTS
Description of Service: Provides assistance and information to client’s inquiries related to patient care. Operating Hours:
Monday to Friday, 8:00 am – 5:00 pm (No Noon Break).
OFFICE Health Information Management Section (HIMS) – Information Unit
TYPE OF
TRANSACTION
WHO MAY AVAIL All clients inquiring on patient’s current status
Valid government issued identification card (1) original copy Government Agencies/Offices
Inquiry Request Form HIMS – Window 5
Notarized authorization if requesting person is not the listed
Patient, Patient’s Relative or Guardian listed as Informant
informant in the patient’s health record (1) original
1. Proceed to Pavilion 2 1. Assess and validates nature None 10 minutes Admin Assistant II
(Window 5) and accomplish of client’s inquiry (HIMS)
Inquiry Request Form
2. Submit accomplished 2.1 Receive request None 15 minutes Admin Assistant II

inquiry form and valid 2.2 Interview client and (HIMS)
government issued assess/validate information
identification card given
3. Proceed to the concerned 3. Endorse/direct client to the None 5 minutes Admin Assistant II
office/pavilion appropriate office/pavilion (HIMS)
65
36. CLINICAL LABORATORY EXAMINATIONS FOR IN-PATIENTS
Description of Service: The Clinical Laboratory is where clinical pathology tests are carried out on clinical specimens to obtain
information about the health of a client to aid in diagnosis, treatment, and prevention of disease. Operating Hours: The service
offered is available 24/7.
OFFICE Clinical Laboratory Section
Simple – General
Examination TYPE OF
CLASSIFICATION Complex – Microbial G2C – Government to Citizen
TRANSACTION
Culture and Sensitivity
WHO MAY AVAIL All in-patients requiring laboratory examination
Laboratory Request Form (1) original copy Pavilion of origin
1. Ward personnel proceeds 1.1 Receive Clinical Laboratory None 5 minutes Laboratory Aide II
to the Clinical Laboratory Request Form for verification Laboratory Tech III
receiving window and 1.2 A. For non-blood Medical Technologist I
submits client’s Clinical specimen: evaluate / II / III
Laboratory Request form specimen for adequacy and (Clinical Laboratory
fitness Section)
For non-blood specimen:
submit specimen B. For routine requests
requiring blood specimen:
For Malasakit Medical schedule blood extraction
Assistance: Ward (morning pick-up)
personnel proceeds to
Malasakit Center and C. For clients availing
present client’s Clinical endowment thru Malasakit
Laboratory Request Form Center: issue charge slip
and Charge Slip and return the verified
Clinical Laboratory Request
form to ward personnel
C.1 Assess for eligibility of 2 hours and 15 Chief, Medical Social

endowment (Refer to minutes Service Section and
Malasakit Center Medical Malasakit Center
Waiting Time: 10 minutes Assistance Procedure) Operations Manager
(Malasakit Center)
2. Ward personnel proceeds 2. Verify the charge slip None 2 minutes Laboratory Aide II
to the Clinical Laboratory Laboratory Tech III
receiving window and Medical Technologist
resubmits Clinical I/ II/ III
Laboratory Request form (Clinical Laboratory
and charge slip approved Section)
by Malasakit Center
Waiting Time: 5 minutes

3. Wait for the arrival of 3. Proceed to the ward to None 30 minutes Laboratory Aide II
Clinical Laboratory perform blood extraction Laboratory Tech III
Personnel to the ward Medical Tech I/ II
Section)
66
4. Ward personnel submits 4. Verify client’s identity thru None 10 minutes Laboratory Aide II
client for blood extraction the ward personnel for blood Laboratory Tech III
extraction, and perform Medical Technologist
blood extraction while being I/ II
assisted by the ward (Clinical Laboratory
personnel Section)
5. Wait for the result 5. Process specimen, generate None 3 hours and 45 Medical Technologist
and validate result minutes - I/ II/ III
General Clinical (Clinical Laboratory
Laboratory Section)
Examination
5 days -
Microbial
Culture and
Sensitivity
Testing
6. Receive official result 6. Release official result to the None 3 minutes Admin Aide III/ VI
personnel at the ward Laboratory Aide II
Section)
6 hours and 50 minutes - General

Examination
5 days and 3 hours - Microbial Culture
and Sensitivity Testing
67
37. CLINICAL LABORATORY EXAMINATIONS FOR OUT-PATIENTS
AND NCMH EMPLOYEES
Description of Service: The Clinical Laboratory is where clinical pathology tests are carried out on clinical specimens to obtain
information about the health of a client to aid in diagnosis, treatment, and prevention of disease. Operating Hours: The service
Simple – General
Examination TYPE OF G2C – Government to Citizen
CLASSIFICATION Complex – Microbial TRANSACTION G2G – Government to Government
WHO MAY AVAIL All out-patients and NCMH employees requiring laboratory examination
Clinical Laboratory Request Form (1) original copy Out Patient Section / Pavilion 7
Valid Government-Issued ID (1) original copy Respective issuing government agencies
PWD or Senior Citizen ID (original copy) Respective issuing agencies
Authorization Letter (if applicable) Client
1. Proceed to the Clinical 1.1 Receive Clinical Laboratory None 5 minutes Laboratory Aide II
Laboratory receiving Request Form for Laboratory Tech III
window and submit Clinical verification Medical Technologist
Laboratory Request Form 1.2 Explain the procedures and I/ II
issue charge slip (Clinical Laboratory
1.3 Return verified Clinical Section)
Laboratory Request Form
for clients availing
endowment thru Malasakit
Center
2. For paying service user: 2. Process the payment and Refer to 10 minutes Administrative Officer
Proceed to the Collection issue official receipt schedule of III (Collection and
and Deposit Unit and fees below Deposit Unit)
provide amount to be paid
For Malasakit Assistance: Assess for eligibility of None 2 hours and 15 Chief, Medical Social
Proceed to Malasakit endowment (Refer to minutes Service Section and
Center and present Clinical Malasakit Center Medical Malasakit Center
Laboratory Request Form Assistance Procedure) Operations Manager
and charge slip (Malasakit Center)
3. Return to the Clinical 3. Verify the official receipt and None 2 minutes Laboratory Aide II
Laboratory receiving charge slip Laboratory Tech III
window and present official Medical Technologist
receipt/ Clinical Laboratory I/ II
Request Form and charge (Clinical Laboratory
slip approved by Malasakit Section)
68
4. For blood examination: 4. Perform blood extraction or None 10 minutes Medical Technologist
proceed to the blood receive specimen I/ II/ III
extraction room (Clinical Laboratory
For non-blood specimen: Section)
submit specimen
5. Wait for the result 5. Process specimen, generate None 3 hours and 45 Medical Technologist
and validate result minutes - I/ II/ III
General Clinical (Clinical Laboratory
Laboratory Section)
Examinations
5 days -
Microbial
Culture and
Sensitivity
Testing
6. Present the charge slip, 6.1 Verify charge slip (if None 3 minutes Admin Aide III/ VI
official receipt, ID, and applicable), official receipt Laboratory Aide II
authorization letter (if and ID (Clinical Laboratory
applicable) to claim the 6.2 Release official result Section)
official result
Refer to
below
fees below

TYPE OF EXAM NON-MALASAKIT CLIENT MALASAKIT CLIENT
General Examination 4 hours and 15 minutes 6 hours and 20 minutes
Microbial Culture and Sensitivity
5 days and 25 minutes 5 days, 2 hours and 30 minutes
Testing
LIST OF FEES FOR CLINICAL LABORATORY EXAMINATIONS

SECTION PROCEDURE CURRENT PRICE
Complete Blood Count (CBC) ₱285.00
Erythrocyte Sedimentation rate (ESR) ₱140.00
Reticulocyte Count ₱275.00
Peripheral Blood Smear ₱370.00
HEMATOLOGY & Malarial Smear ₱180.00
COAGULATION Body Fluid Cell Count and Differential Count ₱240.00
Clotting Time ₱160.00
Bleeding Time ₱160.00
Prothrombin Time (PT) ₱390.00
Partial Thromboplastin Time (PTT) ₱385.00
Blood Typing ₱500.00
BLOOD BANKING Crossmatching ₱930.00
Coomb’s Test ₱855.00
Glucose (FBS/RBS) ₱210.00
CHEMIST
CLINICAL
CHEMIST
BLOOD
Oral Glucose Tolerance Test (OGTT) ₱630.00

RY
RY
Oral Glucose Challenge Test (OGCT) ₱420.00

2-Hour Post-Prandial Test ₱420.00
69
Glycated Hemoglobin/Hemoglobin A1c (HbA1c) ₱890.00
Blood Urea Nitrogen (BUN) ₱190.00
Creatinine ₱200.00
Blood Uric Acid (BUA) ₱200.00
Total Cholesterol ₱200.00
Triglycerides ₱240.00
High-Density Lipoprotein (HDL) ₱360.00
Low-Density Lipoprotein (LDL) ₱360.00
Alkaline Phosphatase ₱260.00
Alanine Aminotransferase (ALT/SGPT) ₱260.00
Aspartate Aminotransferase (AST/SGOT) ₱260.00
Lactate Dehydrogenase (LDH) ₱280.00
Total Bilirubin ₱300.00
Indirect & Direct/Unconjugated & Conjugated Bilirubin ₱300.00
Total Protein ₱290.00
Albumin ₱290.00
Total Protein, Albumin, Globulin, A/G ratio (TPAG) ₱380.00
Sodium ₱220.00
Potassium ₱220.00
Magnesium ₱440.00
Chloride ₱220.00
Total Calcium ₱380.00
Ionized Calcium ₱820.00
Phosphorus ₱400.00
CK Total ₱500.00
CK-MB ₱650.00
CK-MM ₱1,150.00
Amylase ₱450.00
Lipase ₱450.00
Serum Iron with Total Iron Binding Capacity (TIBC) ₱1,000.00
Sodium ₱220.00
CHEMISTRY
Potassium ₱220.00
URINE
Creatinine ₱200.00
Protein ₱290.00
CLINICAL CHEMISTRY
Glucose ₱210.00
BODY FLUID
CHEMISTRY
OTHER
Protein ₱290.00
Lactate Dehydrogenase (LDH) ₱280.00
Valproic Acid ₱2,500.00
(TDM) ASSAY &
THERAPEUTIC
TOXICOLOGY
MONITORING
Carbamazepine ₱2,500.00
DRUG
Lithium ₱1,010.00
Serum Alcohol/Ethanol ₱900.00
Acetaminophen/Paracetamol ₱2,750.00
Urinalysis ₱300.00
Fecalysis ₱130.00
CLINICAL MICROSCOPY Pregnancy Test ₱140.00
Fecal Occult Blood Test (FOBT) ₱195.00
H. pylori Stool Antigen ₱600.00
IMMUNOLOGY & Hepatitis Profile ₱8,597.00
SEROLOGY HBsAg ₱900.00
70
HBeAg ₱1,400.00
Anti-HBs ₱1,000.00
Anti-HBe ₱1,500.00
Anti-HBc IgM ₱1,400.00
Anti-HBc Total ₱1,300.00
Anti-HAV Total (IgG IgM) ₱1,550.00
Anti-HAV IgM ₱1,650.00
Anti-HCV ₱1,800.00
Thyrotropine/ Thyroid Stimulating Hormone (TSH) ₱700.00
Free Tri-iodothyronine (FT3) ₱770.00
Free Thyroxine (FT4) ₱770.00
Prostate Specific Antigen (PSA) ₱1,100.00
IMMUNOLOGY &
HBsAg (Rapid Test) ₱360.00
SEROLOGY
Anti-HBS (Rapid Test) ₱390.00
Anti-HCV (Rapid Test) ₱390.00
Anti-HAV (Rapid Test) ₱390.00
HIV Screening (Rapid Test) FREE
Rapid Plasma Reagin (RPR) ₱230.00
Anti-Treponema pallidum (Rapid Test) ₱195.00
Salmonella IgM, IgG (Rapid Test) ₱510.00
Dengue NS1 (Rapid Test) ₱860.00
Dengue IgM, IgG (Rapid Test) ₱860.00
C-Reactive Protein (CRP) ₱730.00
D-Dimer ₱2,570.00
Procalcitonin ₱3,480.00
Pro-BNP ₱2,860.00
Ferritin ₱1,665.00
Troponin I (Quantitative) ₱1,560.00
Troponin I (Qualitative) ₱450.00
SARS-CoV-2 Rapid Antigen Test ₱300.00
Gram Stain ₱130.00

AFB Stain ₱130.00
KOH Smear ₱130.00
India Ink ₱130.00
Cryptococcal Antigen Test ₱2,000.00
Blood, with ARD/Site ₱1,800.00
MICROBIOLOGY Urine ₱1,450.00
Stool ₱1,450.00
Exudate ₱1,450.00
CSF ₱1,450.00
Throat Swab ₱1,450.00
Rectal Swab ₱1,450.00
Sputum ₱1,450.00
Xpert MTB/RIF (GeneXpert) FREE (under TB-DOTS)
71
38. COMPUTED TOMOGRAPHY SCAN (CT SCAN)
Description of Service: The Radiology Section provides a comprehensive diagnostic imaging service to all client. Operating
Hours: Monday to Friday, 8:00 am – 5:00 pm. Emergency procedures may be done beyond office hours including weekends and
holidays but must be coordinated with the radiology staff.
OFFICE Radiology Section
WHO MAY AVAIL All in-patients, out-patients, and NCMH employees
CT Scan Request Form Requesting physician
Patient’s Chart (For In-Patient only) Pavilion of origin
BUN / Creatinine (for with contrast procedures only) Laboratory Section
Valid Government ID (For Out-Patient) Respective issuing government agencies
1. For In-Patient: The 1.1. Receive CT scan request None 4 minutes Radiologic
Nursing Attendant presents and the patient chart; Technologist
the CT scan request with 1.2. Explain the procedures and Admin Aide
the patient chart. provide schedule (Radiology Section)
1.3. Issue Charge Slip
For Out-Patient and
Employees: Present CT-
scan request
2. Out-Patient and NCMH 2. New Client: Verify client’s None 10 minutes Admin Aide I
Employees: Proceed to name and encode (HIMS)
HIMS for the hospital Sociological Data Sheet
number Old Client: Verify client’s
a. New Client: information
Accomplish
Sociological Data
Sheet
b. Old Client: Present
valid I.D
Paying Service User: Paying service User: Refer to list 10 minutes Admin Officer III
Proceed to Collection and Process the payment and of fees (Collection and
Deposit Unit and provide issue official receipt below Deposit Unit)
amount to be paid
Clients availing Malasakit Clients availing Malasakit None 2 hours and 15 Chief, Medical Social
Assistance: Proceed to Assistance: Assess for minutes Service Section and
Malasakit Center and eligibility of endowment Malasakit Center
present charge slip and (Refer to Malasakit Center Operations Manager
radiology request form Medical Assistance (Malasakit Center)
Procedure)
3. On the scheduled date: 3.1 Receive CT scan request None 5 minutes Radiologic
and patient’s chart; Technologist
For In-Patient: the Nursing 3.2 Encode information at the Administrative Aide
Attendant presents the CT Hospital Management (Radiology Section)
scan request and the Information System; and
patient’s chart.
72
For Out-Patient and 3.3 Verify the Official receipt
Employee: Present the CT and Charge Slip
scan request
Clients availing
Malasakit Assistance:
Present official receipt /
Charge Slip verified by
Malasakit Center
4. Proceed to the CT scan 4. Execute the desired None 1 hour Radiologic
room procedure Technologist
(Radiology Section)
5. Receive result after two (2) 5. Issue result None 2 minutes Radiologic
working days Technologist
Administrative Aide
For In-Patient: For In-Patient: Official result (Radiology Section)
The receiving medical The official result will be will be issued
personnel writes his / her delivered to the respective after two (2)
name and signs in the pavilion working days
releasing folder
For Out-Patient and

Employee:
Present valid I.D
2 days, 1 hour, and 21 minutes -

Refer to Paying Service User
fees below 2 days, 3 hours, and 26 minutes -
Malasakit Center Client
73
LIST OF FEES FOR CT SCAN PROCEDURE
READER’S FEE
(FOR PAYING
CT SCAN PROCEDURE RATE (Php)
SERVICE USERS
ONLY)
1 Adrenals (Contrast Enhanced) 7,000.00 1,000.00
2 Cranial (Plain) 4,000.00 1,000.00
3 Cranial (Contrast Enhanced) 4,000.00 1,000.00
4 Chest (Plain) 4,000.00 1,000.00
5 Chest (Contrast Enhanced) 6,000.00 1,000.00
6 Neck 5,000.00 1,000.00
7 Neck (Contrast Enhanced) 6,000.00 1,000.00
8 Orbits 5,000.00 1,000.00
9 Orbits (Contrast Enhanced) 6,000.00 1,000.00
10 PNS 4,000.00 1,000.00
11 PNS (Contrast Enhanced) 5,000.00 1,000.00
12 Temporal Bone 5,000.00 1,000.00
13 Nasopharanx / Oral Cavity 5,000.00 1,000.00
14 Nasopharanx / Oral Cavity (Contrast Enhanced) 6,500.00 1,000.00
15 Facial Bone 5,500.00 1,000.00
16 Thoracic Spine 4,500.00 1,000.00
17 Thoracic Spine (Contrast Enhanced) 5,500.00 1,000.00
18 Lumbosacral Spine 5,000.00 1,000.00
19 Lumbosacral Spine (Contrast Enhanced) 5,500.00 1,000.00
20 Whole Abdomen 9,000.00 1,400.00
21 Whole Abdomen (Single Phase Contrast/ Triple Contrast) 10,000.00 1,500.00
22 Whole Abdomen (Triple Phase Contrast/ Triphasic Protocol Contrast) 11,000.00 2,000.00
23 Upper Abdomen 5,500.00 1,000.00
24 Upper Abdomen (Single Phase Contrast) 6,000.00 1,000.00
25 Upper Abdomen (Triple Phase Contrast) 8,000.00 1,000.00
26 Lower Abdomen 5,500.00 1,000.00
27 Lower Abdomen (Contrast Enhanced) 6,000.00 1,000.00
28 Extremities 5,000.00 1,000.00
29 Extremities (Contrast Enhanced) 5,000.00 1,000.00
30 Pelvis 4,500.00 1,000.00
31 CT Guided Biopsy 12,500.00 3,000.00
32 Stonogram 6,200.00 1,000.00
33 CT Angiography (Brain) 11,000.00 3,000.00
34 Cervical (Plain) 5,000.00 1,000.00
35 Cervical (Contrast Enhanced) 5,500.00 1,000.00
36 CT Urogram 9,000.00 1,500.00
37 Pituitary Fossa / Sella 3,500.00 1,000.00
38 Power Injector Syringe (To all contrast procedures) 1,000.00 -
39 3D Reconstruction 1,000.00 -
40 Printing of Images (per 14 x 7 film) 200.00 -
Note: Sedation, Contrast Media and Other Supplies are not included in the procedure;
Contrast media 50ml – ₱1,900.00; Contrast media 100ml – ₱2,000.00
74
39. COVID-19 RT-PCR COLLECTION AND TESTING
Description of Service: The Clinical Laboratory Section is where client’s nasopharyngeal and oropharyngeal swab samples are
collected, submitted to the Subnational Laboratory and other referral laboratories, and tested for SARS-CoV-2. Operating Hours:
The service is available 24/7.
WHO MAY AVAIL All in-patients and NCMH employees
Case Investigation Form (1) original copy Patient’s Ward/ Triage Area
Philhealth Patients: Philhealth Claim Form 2 (1) original copy Philhealth Unit/ Patient’s Ward
Clinical Laboratory Request Form (1) original copy Patient’s ward / Triage area
Charge Slip Clinical Laboratory
Acknowledgement Slip for Medical Assistance Patient’s Ward
1. Submit applicable 1. Verify requirements for None 10 minutes Laboratory Aide II
requirements to the Clinical completeness of data Lab Tech III
Laboratory receiving Med Tech I / II
window For paying service user: (Clinical Laboratory
Issue charge slip Section)
2. For clients availing the 2. For clients availing the None 2 hours and 15 Chief, Medical Social
Malasakit Medical Malasakit Medical minutes Service Section and
Assistance: Ward Assistance: Malasakit Center
personnel proceeds to Assess for eligibility of Operations Manager
Malasakit Center and endowment (Malasakit Center)
present client’s Clinical
Laboratory Request form
and Charge slip (Refer to
Malasakit Center medical
Assistance procedure)
For clients availing the For clients availing the None 10 minutes Admin Aide I – VI
Philhealth Assistance: Philhealth Assistance: (Claims Unit)
ward personnel/employee verify requirements for
submits clients’ Case completeness of data
Investigation Form (CIF)
to the Clinical Laboratory
receiving window
For paying service user: For paying service user: Php1,700 10 minutes Admin Officer III
Proceed to Collection and Process the payment and (c/o referral (Collection and
deposit Unit and provide issue official receipt testing Deposit Unit)
amount to be paid laboratory)
3. Wait for the arrival of 3. Proceed to the ward to None 30 minutes Lab Tech III
Clinical Laboratory perform swab sample Med Tech I / II
Personnel to the ward collection from patient (Clinical Laboratory
Section)
75
4. Swab sample collection: 4.1 Verify client’s identity for None 10 minutes Nursing Attendant
swabbing Nurse I / II
For in-patient: Ward 4.2 Perform swab sample (Ward)
personnel submits client for collection Med. Lab. Tech III
swab collection Med Tech I / II
The ward personnel assist (Clinical Laboratory
For NCMH employees: the clinical laboratory Section)
Proceed to swab sample personnel in the procedure Nursing Attendant
collection area at the at all times Nurse I / II
Clinical Laboratory (Ward)
5. Wait for the result 5.1 Prepare collected swab None 10 minutes Med Tech I / II
samples and perform proper (Clinical Laboratory
packaging technique prior to Section)
sending and testing to the
subnational and other
referral laboratories
5.2 Submit swabs samples to None 4 hours Laboratory Aide II
Subnational and other Laboratory
referral laboratories for Technician III
testing Medical
Technologist I
Section)
5.3 Conduct PCR testing None 2 days Subnational and

other referral
laboratories
6. Receive official result 6. Release official result to the None 3 minutes Laboratory Aide II
ward personnel Laboratory
Technician III
Medical
Technologist I
Section)
2 days, 7 hours, and 8 minutes –
Php1,700 – Malasakit Center Clients
for paying
END OF TRANSACTION
service 2 days, 5 hours, and 3 minutes –
users only Paying service users / Clients with
Philhealth
76
40. DISPENSING OF DRUGS AND MEDICINES
Description of Service: The Pharmacy Section caters to all clients availing medicines. Operating Hours: Monday to Sunday,
except for holidays; 7:00 am to 7:00 pm (No Noon Break).
OFFICE Pharmacy Section
For In-Patient:
Attending Physician
▪ Prescription (1) original copy
Pavilion of Origin
▪ Weekly Requisition Record Sheet
For OPS / Pay / POS client:
▪ Prescription (1) original copy
(Valid Date of Prescription, quantity of medicines relatively to its Attending Physician
SIGNA)
For dangerous drugs:
Attending Physician
▪ S2 prescription (3) original copies
Any government agency
▪ Valid government issued I.D (1) original copy
PWD/ Senior Citizen’s ID (for discount) Local Government Agency

1. For purchase of 1.1 Verify prescription and other None 5 minutes Admin Aide I
medicine: supporting documents if (Pharmacy Section)
Proceed to the Pharmacy applicable Weekdays
Section and present 1.2 Check availability of
prescription medicines requested Pharmacist II
1.3 Issue order of payment/ (Pharmacy Section)
For dangerous drugs: prescription with price Weekends
Submit three (3) copies of
the prescription and
present one (1) valid
government issued ID
For DOH-MAP donations:

Proceed to the Pharmacy
Section window 16 and
present stamped
prescription (proceed to
step 3)
For In-Patient request of

medicine: Proceed to the
Pharmacy window 15 and
present prescription
(proceed to step 3)
2. For purchase of 2. Process the payment and Price of 10 minutes Admin Officer III
medicine: issue official receipt medicine x (Collection and
quantity = Deposit Unit)
77
Proceed to the Collecting amount to
Window and provide be paid
amount to be paid
3. For purchase of 3.1 Verify official receipt/ None 5 minutes Pharmacist II

medicine: Return to approved prescription (Pharmacy Section)
Pharmacy window 17 and 3.2 Issue requested
present official receipt and medicines
receive medicines
For medicine assistance:

Present approved
prescriptions from
Malasakit Center and
receive medicines
For DOH-MAP Receive

medicine
For In-Patient: Receive

medicine
Price of
medicine x
END OF TRANSACTION quantity = 20 minutes
amount to
be paid
78
PRICELIST OF DRUGS AND MEDICINE
NAME OF DRUGS / MEDICINES SELLING PRICE
Acetylcysteine 600 mg Effervescent Tablet x 10's ₱21.00
Acetylcysteine 600 mg Effervescent Tablet x 20's ₱28.00
Aciclovir 400 mg Tablet x 30's ₱18.25
Allopurinol 300 mg Tablet x 100's ₱4.25
Aripiprazole 10 mg Tablet x 100's ₱77.50
Aripiprazole 300mg(200mg/ml) Pre-filled Syringe x 1's ₱8,207.00
Aripiprazole 400mg(200mg/ml) Pre-filled Syringe x 1's ₱8,207.00
Atorvastatin 10 mg Tablet x 100's ₱3.50
Betahistine 16 mg Tablet x 100's ₱17.50
Biperiden 2 mg Tablet x 100's ₱57.50
Carvedilol 25 mg Tablet x 30's ₱6.50
Carvedilol 6.25 mg Tablet x 15's ₱2.00
Celecoxib 200 mg Capsule x 60's ₱5.00
Clozapine 100 mg Tablet x 100's ₱9.00
79
Diphenhydramine 50 mg Capsule x 100's ₱1.75
Divalproex Sodium 250 mg ER Tablet x 10's ₱17.75
Divalproex Sodium 250 mg ER x 10's ₱17.25
Divalproex Sodium 250 mg Tablet x 100's ₱33.50
Divalproex Sodium 250 mg x 100's ₱21.00
Divalproex Sodium 500 mg x 10's ₱21.25
Domperidone 10 mg ODT x 100's ₱3.75
Donepezil 10 mg ODT x 100's ₱57.50
Donepezil 10 mg Tablet x 30's ₱17.75
Epoetin Alfa 4000 IU / ml Pre-filled Syringe x 10's ₱500.50
Epoetin Alfa 4000 IU / ml Pre-filled Syringe x 6's ₱499.25
Escitalopram 10 mg Tablet x 100's ₱28.00
Felodipine 5 mg Tablet x 100's ₱14.50
Fenofibrate 160 mg Capsule x 100's ₱38.00
Fenofibrate 160 mg Tablet x 30's ₱39.25
Fluoxetine 20 mg Capsule x 30's ₱32.25
Fluphenazine Decanoate 25mg/ml Ampoule x 5's ₱111.75
Fluphenazine Decanoate 25mg/ml x 5's ₱111.75
Fluphentixol Decanoate 20mg/ml x 10's ₱447.25
Folic Acid 5 mg Tablet x 100's ₱4.50
Gliclazide 30 mg MR Tablet x 30's ₱3.75
Gliclazide 30 mg Tablet x 100's ₱3.50
Haloperidol 5 mg Tablet x 100's ₱5.75
Isosorbide Mononitrate 60 mg x 70's ₱10.00
80
Lamotrigine 100 mg Tablet x 30's ₱26.75
Levetiracetam 1000 mg Tablet x 60's ₱49.00
Levetiracetam 100mg/mL(500mg/mL) IV x 10's ₱1,950.00
Levetiracetam 100mg/mL(500mg/mL) IV x 1's ₱1,716.00
Levodopa + Carbidopa 100 mg / 25 mg Tablet x 100's ₱22.25
Levodopa + Carbidopa 100mg/25mg Tablet x 100's ₱23.75
Levomepromazine 100 mg Tablet x 100's ₱31.00
Levothyroxin 100mcg Tablet x 100's ₱9.00
Levothyroxin 150mcg Tablet x 100's ₱14.25
Lithium Carbonate 450 mg Tablet x 100's ₱6.25
Losartan 100 mg Tablet x 100's ₱3.75
Memantine 10 mg Tablet x 100's ₱28.50
Metformin 500 mg ER Tablet x 30's ₱1.25
Metformin 500 mg Tablet x 100's ₱1.25
Montelukast 10 mg Tablet x 100's ₱10.25
Olanzapine 10 mg ODT x 100's ₱26.25
Olanzapine 10 mg Tablet x 100's ₱6.00
Olanzapine ODT 10 mg Tablet x 100's ₱21.00
81
Oral Rehydration Salts Sachet x 25's ₱6.75
Oral Rehydration Salts x 25's ₱6.75
Pantoprazole 20 mg Tablet x 30's ₱30.25
Pantoprazole 40 mg Tablet x 30's ₱27.50
Potassium Chloride 750 mg SRTablet x 50's ₱16.50
Potassium Citrate 1080mg Tabet x 30's ₱10.00
Propranolol 10 mg Tabelet x 100's ₱9.00
Propranolol 10 mg Tablet x 100's ₱2.25
Quetiapine 100 mg Tablet x 50's ₱21.00
Risperidone 1 mg Tablet x 10's ₱11.50
Risperidone 2 mg Orosdispersible Tablet x 28's ₱50.50
Rosuvastatin 10 mg Tablet x 30's ₱7.25
Rosuvastatin 20 mg Tablet x 30's ₱12.00
Sertraline 50 mg Tablet x 100's ₱10.00
Sodium Valproate + Valproic Acid 500mg Tablet x 100's ₱14.75
Tamsulosin 200 mcg Tablet x 100's ₱19.75
82
Tamsulosin 200 mcg Tablet x 30's ₱53.25
Telmisartan 40 mg Tablet x 100's ₱8.50
Trimetazidine 35mg Tablet x 100's ₱6.00
Ursodeoxycholic Acid 250 mg Capsule x 100's ₱54.25
Valproic Acid + Sodium Valproate 333 mg / 145 mg Controlled Release Tablet x 50's ₱10.00
Valsartan 160 mg Tablet x 30's ₱19.00
Verapamil 80 mg Tablet x 100's ₱26.25
All prices are subject to change without prior notice
83
41. DRUG TESTING
Description of Service: This DOH accredited drug testing unit offers screening drug tests which can be used for the following
purposes: pre-employment, application of S2 license for licensed physicians, application for firearm’s license and permit to carry
firearms, and others. Operating Hours: Monday to Friday, 08:00 am – 05:00 pm (No noon break).
OFFICE Anatomical Laboratory Section – Drug Testing Unit
WHO MAY AVAIL All Citizens and NCMH employees for promotion
Drug Testing Request Form (if available) Requesting agency / physician
Valid Government Issued ID / Company ID / School ID Respective Agencies
Authorization Letter (if applicable) To be provided by the Client
1. Proceed to Drug Testing 1. Receive Drug Testing None 3 minutes Laboratory Aide
Unit and submit request Request for verification and Laboratory Technician
issue Charge Slip Med Tech I, II
(Drug Testing Unit)
2. Proceed to the Collection 2. Process the payment and 2 Panel – 10 minutes Administrative
and Deposit Unit and issue Official Receipt Php250.00 Officer III
provide amount to be paid (Collection and
6 Panel – Deposit Unit)
Php1,500.00
3. Return to Drug Testing 3.1 Verify Official Receipt None 5 minutes Laboratory Aide
Unit and present Official 3.2 Issue the following forms: Laboratory Technician
Receipt ▪ Client Information Sheet Med Tech I, II
▪ Verification Form (Drug Testing
▪ Drug Testing Consent Unit)
▪ Custody and Control Form
4. Fill out the forms and 4.1 Receive and check the None 10 minutes Laboratory Aide
submit accomplished forms Laboratory Technician
4.2 Instruct the client regarding Med Tech I, II
proper urine collection (Drug Testing Unit)
5. Submit the urine 5.1 Receive the urine specimen None 10 minutes Med Tech I, II, III
specimen and label the container (Drug Testing
accordingly Unit)
5.2 Testing of urine specimen
6. Submit self for photo and 6. Conduct photo and None 10 minutes Med Tech I, II, III
biometrics capturing biometrics capturing (Drug Testing Unit)
7. Present the official 7.1 Verify official receipt None 2 minutes Laboratory Aide
receipt, valid ID and 7.2 Issue official result Laboratory Technician
authorization letter (if Med Tech I, II
applicable) to claim the (Drug Testing Unit)
official result
2 Panel –
Php250.00
END OF TRANSACTION 50 minutes
6 Panel –
Php1,500.00
84
42. ELECTROENCEPHALOGRAM (EEG) / ELECTROMYOGRAM
AND NERVE CONDUCTION VELOCITY (EMG-NCV)
Description of Service: This process is to provide the service users guidelines in utilization of Neurophysiology Laboratory
examinations. Operating Hours: Monday to Friday, 8:00 am - 5:00 pm (No noon break). PAVILION 2 RM 221, Tel No: 8531 9001
loc 295/1501
OFFICE Neurological Unit-Neurophysiology Laboratory
TYPE OF
CLASSIFICATION Simple G2G – Government to Citizen
TRANSACTION
Scheduling of Procedure:
EEG or EMG-NCV Request Form (1) original copy Referring Physician/Consultant
Triage Form (1) original copy OPS Triage
On the Day of Schedule:
Triage Form (1) original copy OPS Triage
EEG or EMG-NCV Request Form (1) original copy Referring Physician/Consultant
Approved Charge Slip (Service User from NCMH) Malasakit Center
Official Receipt (Service User from Other Hospital or Clinics) Collection and Deposit Unit
Releasing of Official Result:
Valid Identification Card (1) original copy
For representative:
Letter of Authorization Service User
Valid Identification Card of the service user (1) photocopy
Valid Identification Card of the representative (1) original copy
1. Proceed to Triage area and 1. Verify health declaration None 5 minutes Nurse I / II
accomplish a health form (Triage Area)
declaration form
2. Proceed to 2.1 Verify request and schedule None 5 minutes Admin Assistant I
Neurophysiology the procedure (Neurophysiology
Laboratory and present the 2.2 Issue charge slip Laboratory)
EEG Request Form or
referral slip
3. A. For paying service 3. Receive the payment and ₱1,900.00 - 10 minutes Admin Officer III
user: Proceed to Collection issue official receipt EEG (Collection and
and Deposit Unit and Deposit Unit)
provide the amount to be ₱3,422.00 -
paid EMG-NCV
Uppers or
Lowers
₱5,000.00 -
EMG-NCV
of All
Extremities
85
4. B. For clients availing the 4. Assess for eligibility of None 2 hours and 15 Chief, Medical Social
Malasakit Assistance: endowment minutes Service Section and
Proceed to Malasakit Malasakit Center
Center Operations Manager
(Refer to Malasakit Center (Malasakit Center)
Medical Assistance
Procedure)
5. On the day of schedule, 5. Verify request and charge None 5 minutes Admin Assistant I
proceed to slip/official receipt (Neurophysiology
Neurophysiology Laboratory)
Laboratory and present
request and approved
charge slip/official receipt
6. Undergo the procedure 6. Conduct the procedure None 1 hour Neurophysiology
Technician /
Electromyographer
((Neurophysiology
Laboratory)
7. Receive official result 7. Release result None 5 minutes Admin Assistant I

(Neurophysiology
Note: Official Laboratory)
result is
available after
three (3)
working days
3 days, 1 hour, and 30 minutes –
Paying service user
Refer to
3 days, 3 hours, and 35 minutes –
fees below
Clients availing the Malasakit
Assistance
Schedule of Fees AMOUNT
Paying Service User
EEG ₱1,900.00
EMG-NCV Uppers or Lowers ₱3,422.00
EMG-NCV of all extremities ₱5,000.00
Clients availing the Malasakit Assistance None
86
43. HISTOPATHOLOGY SERVICES
Description of Service: The Histopathology Unit provides diagnostic services for surgical pathology, cytology, and gynecologic
cytology to aid in the diagnosis and management of patients. Operating Hours: Monday – Friday 08:00 am – 05:00 pm (No noon
break)
OFFICE Anatomical Laboratory Section – Histopathology Unit
Histopathology Request Form (1) original copy Requesting physician / pavilion / ward
Properly labelled specimen Requesting physician / pavilion / ward
Official Receipt (1) original copy Collection and Deposit Unit
PWD / Senior Citizen ID of patient (if applicable) (1) original
Respective issuing government agencies
copy
Valid Government Issued ID / Company ID, School ID (1)
Respective issuing agencies
original copy
Authorization Letter (if applicable) To be provided by the client
1. For In-Patient: The 1.1 Verify and check for the None 5 minutes Laboratory Aide
Nursing Attendant presents completeness of the request Laboratory Technician
the Histopathology request form and check for the Medical Technologist
with the properly labelled adequacy of the specimen (Histopathology
specimen to the Anatomic fixative. Unit)
Laboratory Personnel at 1.2 Explain the procedure and
the Anatomic Laboratory issue charge slip
1.3 Return verified
For Out-Patient: Present Histopathology request for
the Histopathology request clients availing endowment
with the properly labelled thru Malasakit Center
specimen to the Anatomic
Laboratory Personnel at
the Drug Testing Unit
2 For Out-Patient: Proceed 2. Process the payment and Refer to 10 minutes Administrative Officer
to the Collection and issue the official receipt schedule of III (Collection and
Deposit Unit and provide fees below Deposit Unit)
the amount to be paid
Malasakit Assistance: Assess for eligibility of None 2 hours and 15 Chief, Medical Social
Proceed to Malasakit endowment (Refer to minutes Service Section and
Center, present the charge Malasakit Center Medical Malasakit Center
slip and Histopathology Assistance Procedure) Operations Manager
Request Form (Malasakit Center)
3. Return to the Anatomic 3.1 Verify the Official Receipt None 5 minutes Laboratory Aide
Laboratory and present the and Charge Slip Laboratory Technician
following: 3.2 Advice the Turn Around Medical Technologist
For Out-Patient: Official Time for the Official Result (Histopathology
Receipt Unit)
87
Malasakit Assistance: 3.3 Process specimen and Refer to Medical Technologist
Official Receipt, generate the result Processing Medical Officer IV
Histopathology Request Time Table Medical Specialist IV
form and Charge Slip below (Histopathology
verified by the Malasakit Unit)
Center
4. Claim result after Turn 4. Releasing of results None 2 minutes Laboratory Aide
Around Time
For In-Patient: Once the
For In-Patient: The official result is available, the
receiving personnel writes Anatomic Laboratory
his / her name and Personnel shall inform the
signature on the receiving specific Pavilion / Ward and
copy of the result shall deliver a copy of the
result to the respective
For Out-Patient and wards
NCMH Employee: Present
valid ID and authorization For Out-Patient and NCMH
letter if applicable Employee: The official
result shall be released to
the patient or relative
Refer to
below
fees below
LIST OF FEES FOR HISTOPATHOLOGY SERVICES

READER’S FEE
PROCEDURE PROCESSING FEE
(FOR PAY PATIENTS ONLY)
Fine Needle Aspiration Biopsy ₱300.00 ₱300.00
Fluid Cytology with Cell Block ₱500.00 ₱300.00
Pap Smear ₱250.00 ₱150.00
Small Biopsy ₱500.00 ₱500.00
Medium Biopsy ₱800.00 ₱800.00
Large Biopsy ₱1200.00 ₱1200.00
Extra Large Biopsy ₱2000.00 ₱2000.00
Double Extra-Large Biopsy ₱2500.00 ₱2500.00

TYPE OF EXAM NON-MALASAKIT CLIENT MALASAKIT CLIENT
▪ Pap Smear
5 days and 22 minutes 5 days, 2 hours, and 27 minutes
▪ Fine Needle Aspiration Biopsy
▪ Small to Medium Biopsy
▪ Fluid Cystology with Cell Block
▪ Large to Double extra Large
Biopsy Specimens
88
44. MALASAKIT CENTER MEDICAL ASSISTANCE
Description of Service: It is a one-stop shop for all government medical and financial assistance for all Filipinos, particularly the
indigent and financially incapacitated clients. Operating Hours: Monday to Sunday, 7:00 am – 7:00 pm (No Noon Break).
OFFICE Malasakit Center
WHO MAY AVAIL All Filipino citizens
Laboratory and/or Radiology Request Form and/or CT Scan
Request Form and/or Hospital Bill and/or triplicate copies of Requesting physician
prescription from OPS
Certificate of Indigency (1) original copy Barangay or MSWDO/CSWDO
Valid ID of patient or PWD ID Government agencies/ Issuing agencies
Valid ID of immediate relative Respective issuing agencies
Updated Clinical Abstract (for dialysis patients) (1) original copy Physician-in-Charge
Updated Prescription (for dialysis patients) (1) original copy Physician-in-Charge
Certificate of Cohabitation (if claimant is in a common-law
Barangay or MSWDO/CSWDO
relationship with the patient) (1) original copy
Certificate of Guardianship (if claimant is other than the patient
Barangay or MSWDO/CSWDO
or his/her immediate family) (1) original copy
Medical Clearance for vaccination (for NCMH Employees and
Pavilion 7- General Hospital
their dependents) (1) original copy
Note: Malasakit Center will only allow immediate family as claimant on behalf of the patient. Immediate family members are
limited to LEGAL SPOUSE, CHILDREN, PARENTS AND SIBLINGS OF THE PATIENT.
1. For Hospital Bill 1. For Hospital Bill None 5 minutes Administrative Officer
Assistance: Proceed to Assistance: Issue Hospital (Billing Unit)
Billing Section to obtain Bill
hospital bill
For Medicine Assistance: For Medicine Assistance: 30 minutes Chief, Medical Social
Proceed to window 19 and Review the completeness of Service Section and
submit necessary the submitted documentary Malasakit Center
requirements requirements Operations Manager
(Malasakit Center)
For Diagnostic For Diagnostic 5 minutes Laboratory Aide

Procedures: Proceed to Procedures: Issue charge Laboratory Technician
Radiology/Laboratory slip Medical Technologist
Section and present (Laboratory and
Request Form for issuance Radiology Section)
of charge slip
2. Proceed to Malasakit 2.1 Review and verifies the None 10 minutes Chief, Medical Social
Center and present the authenticity of the Service Section and
requirements to the requirements presented Malasakit Center
Malasakit Center Front 2.2 If found complete, issue Operations Manager
Desk Officers for Screening Acknowledgement Slip and (Malasakit Center)
Unified Intake Sheet; and
89
Waiting time: 30 minutes If incomplete, direct client to
step 1
3. Fill out the 3.1 Endorse the documents to None 30 minutes Chief, Medical Social
Acknowledgement Slip and Administrative Aide IV for Service Section and
Unified Intake Sheet and pricing of prescription and or Malasakit Center
submit window 19 checking with Malasakit Operations Manager
Center database (Malasakit Center)
3.2 Endorse to social worker for
approval
4. Proceed to window 21 and 4.1 Assess the eligibility of None 1 hour Chief, Medical Social
wait for your name to be client/claimant and approve Service Section and
called the requested assistance Malasakit Center
4.2 Endorse the approved Operations Manager
request/s to Administrative (Malasakit Center)
Aide IV for releasing
Waiting time: 2 hours
5. Receive the approved 5.1 Issue approved prescription None 30 minutes Chief, Medical Social
prescription and/or charge and/or charge slip and/or Service Section and
slip and/or hospital bill, and hospital bill Malasakit Center
proceed to the 5.2 Instruct client to proceed to Operations Manager
corresponding section the corresponding section (Malasakit Center)
specifically assigned for specifically assigned for
their necessary assistance their necessary assistance
For hospital bill assistance: Billing – Unit Head

Proceed to Billing Unit
For medicine assistance: Chief, Pharmacy

Proceed to Pharmacy Section
Section
For Diagnostic Procedures Chief, Radiologic

assistance: Proceed to Technologist
Laboratory Section and/or
Radiology Section Chief, Medical
Technologist
2 hours and 40 minutes for Medicine
Assistance
2 hours and 15 minutes for Billing and
Diagnostic Procedure Assistance
90
45. NEUROPSYCHIATRIC ASSESSMENT AND PSYCHOLOGICAL TESTING
Description of Service: The Psychological Section is tasked in administering different Neuropsychiatric and Psychological
examinations that will determine the cognitive and behavioral functioning of an individual. Operating Hours: Monday to Friday
except Thursday and holidays; 7:00 am – 4:00 pm.
OFFICE Psychological Section
TRANSACTION
WHO MAY AVAIL All clients requiring Neuropsychiatric Assessment and Psychological Examination
Schedule Slip Psychological Section’s Neuropsychiatric Assessment Unit
Referral Letter (1) original copy From clients’ respective offices/agencies
2x2 ID Picture with white background (1) copy To be provided by the client
Charge Slip (1) original copy Psychological Section’s Neuropsychiatric Assessment Unit
1. Walk-in or call the 1. Issue the Schedule Slip (for None 5 minutes Admin Assistant I
Psychological Section to walk-ins) or verbal schedule (Psychological
inquire on the available confirmation through phone Section)
schedule for inquiries
Neuropsychiatric
Assessment.
2. On the scheduled date, 2. Receive Referral Slip/Letter None 5 minutes Admin Assistant I
proceed to the and verify schedule (Psychological
Psychological Section, Section)
present the Referral
Slip/Letter and sign the
Attendance Sheet
3. Proceed to the Testing 3.1 Administer the battery of None 6 Hours Psychologist II
Room and undertake the Psychological Tests (Psychological
examination and interview 3.2 Conduct Interview Section)
3.3 Check the completeness of
the examination
4. Receive Charge Slip for 4. Issue the Charge Slip None 2 minutes Admin Assistant I
payment of psychological (Psychological
exam fee Section)
5. Proceed to the Collection 5. Process the payment and See pricelist 10 minutes Admin Officer III
and Deposit Unit and pay issue official receipt below (Collection and
the required amount Deposit Unit)
91
6. Return to the Psychological 6.1 Record official receipt None 14 Working Admin Assistant I
Section and present official number and provide Days Psychologist II
receipt schedule of release of (Psychological
Psychological Report Section)
6.2 Score and interpret the
administered psychological
tests
6.3 Prepare comprehensive
psychological reports
7. Return on the scheduled 7.1 Verify schedule of release of None 10 minutes Admin Assistant I
date/time of release of the Official Report and (Psychological
Psychological Report and documents submitted. Section)
present one (1) valid 7.2 Issue the Psychological
government issued ID Report
If with a representative,
submit the Letter of
Authorization and
photocopy of one (1) valid
government issued ID of
both the client and
representative
See price
END OF TRANSACTION 14 days 6 hours 32 minutes
list below
PSYCHOLOGICAL EXAM FEES AMOUNT
₱1,900.00
Certificate of Mental Fitness (Internal/External)
FREE for internal
NEURO-PSYCHIATRIC ASSESSMENT UNIT (NPAU)
A. NCMH Administrative Personnel
1. Rank and File (SG 9 and below) FREE
2. Rank and File (SG 10 – 17) FREE
3. Supervisory (SG 18 – 21) ₱1,900.00
4. Managerial (SG 22 and above) ₱2,160.00
B. Nursing Personnel and other positions under patient care (internal/external)
₱1,580.00
1. Nursing Attendant and others (SG 9 and below)
FREE for internal
₱1,900.00
2. Nurse I and II (SG 15 - 16)
FREE for internal
3. Nurse II (SG 16 – For promotion) ₱1,900.00
4. Nurse III and above (SG 17 and above – Supervisory) ₱2,160.00
C. Doctors and other positions involving patient care (internal/external)
1. Medical Officer III and IV (SG 18 and 20; entry) ₱1,900.00
2. Medical Specialist and other Managerial Positions (SG 22 and above; entry or promotion) ₱2,160.00
SPECIALIZED POPULATION (ATTORNEYS, PROSECUTOR, OTHER GOVERNMENT AGENCIES)
1. Other Government Agencies (Rank and File) ₱1,580.00
2. Other Government Agencies (Supervisory/Managerial) ₱2,160.00
3. PAO Attorney and Prosecutor (Entry and Renewal) and other government agencies (SG 16 to 21) ₱1,580.00
4. PAO Attorney and Prosecutor (5th year in office) ₱2,160.00
5. Director Level and above (SG 22 and above) ₱2,160.00
6. Private Agencies (Rank and File) ₱1,580.00
7. Private Agencies (Supervisory/Managerial) ₱2,160.00
92
46. NUTRITION CONSULTATION
Description of Service: This process is established to provide individualized nutrition assessment, diagnosis, interventions,
monitoring and evaluation for referred outpatient service users (psychiatric/ medical) who are nutritionally at risk or screened for
malnutrition. Operating Hours: Monday to Friday, except for holidays, 8:00 am – 5:00 pm.
OFFICE Nutrition and Dietetic Section
TYPE OF
TRANSACTION
WHO MAY AVAIL Referred Service Users who are nutritionally at risk or screened for malnutrition
Nutrition request form or Doctor’s order form Physician-in-charge
Service User’s Chart Pavilion of origin
1. On the scheduled date, 1. Receive and check the None 5 minutes Nutritionist Dietitian II
proceed to Pavilion 2 completeness of Nutrition (Pavilion 2 Nutrition
Nutrition Clinic and request form Clinic)
present the Nutrition
request form or Doctor’s
Order Form
2. Receive Nutrition 2.1 Check the service user’s None 15 minutes Nutritionist Dietitian II
Assessment chart to gather pertinent (Pavilion 2 Nutrition
information and data which Clinic)
include physician’s order,
medical history, physical
examination, laboratory test
results
2.2 Check the actual height and
weight of the service user
using a calibrated
measuring tool
2.3 Nutrition assessment data
shall be recorded to
Nutritionist-Dietitian
Assessment form
3. Receive the Nutrition Plan 3.1 Provide nutrition plan, None 30 minutes Nutritionist Dietitian II
and Nutrition Counseling/ sample meal plan guide (Pavilion 2 Nutrition
Education and/ or diet instructional Clinic)
materials
3.2 Schedule follow- up visit if
applicable
93
47. OCCUPATIONAL THERAPY SERVICES
Description of Service: Occupational Therapy is one of the services under the Activity Therapy Section which focuses on providing
effective therapeutic activities to all referred service users. Operating Hours: Monday to Friday, 8:00 am – 5:00 pm (No Noon
Break).
OFFICE Activity Therapy Section – Occupational Therapy Unit
TYPE OF
TRANSACTION
WHO MAY AVAIL All referred in-patients
Referral for Occupational Therapy Form Physician in charge/ Pavilion of origin
Doctor’s Order Physician in charge/ Pavilion of origin
Patient’s Chart Pavilion of origin
1. NOD notifies the OT Unit 1. 1 Receive OT Referral Form None 15 minutes OTT I, OTT II, OT I
of the referral and referral orders (ATS – OT Unit)
1. 2 Acquire relevant
information in the chart
1. 3 Schedule client for
evaluation
2. Undergo evaluation 2.1 Fetch service user from the None 2 hours OTT I, OTT II, OT I
ward to the OT area (ATS – OT Unit)
2.2 Conduct interview,
assessment, and accomplish
OT Priority Checklist
2.3 Schedule the patient for
treatment
2.4 Accomplish Evaluation and
Plan of Treatment
3. On the day of schedule, 3.1 Fetch service user from the None 2 hours and 35 OTT I, OTT II, OT I
undergo treatment ward to the OT area minutes (ATS – OT Unit)
3.2 Conduct treatment
3.3 Schedule the patient for the
next treatment
3.4 Accomplish report and plan
the next activity (Treatment
for re-evaluation)
Frequency of Re-evaluation: Monthly to quarterly if the condition remains stable for extended periods of time.
94
48. PERSONAL GROOMING SERVICES
Description of Service: The Personal Grooming Service is one of the services under the Activity Therapy Section, which ensures
the proper grooming of all the NCMH service users. Operating Hours: Monday to Friday, except for holidays; 8:00 am to 5:00 pm
(No Noon Break).
OFFICE Activity Therapy Section
TYPE OF
TRANSACTION
Request form (1) original copy Activity Therapy Section
1. Submit the request form 1. Receive and verify the None 1 minute Admin Aide I
request (ATS Section)
2. Receive schedule 2. Notify the requesting None 1 minute Admin Aide I

pavilion for the schedule (ATS Section)
3. The Nursing Attendant 3.1 Perform the requested See pricelist 10 minutes Barber
prepares and assists the service below Haircut (ATS)
client for grooming 3.2 Accomplish charge slip and
submit to the Billing Unit 2 minutes
Shave
Please see 12 minutes – haircut
END OF TRANSACTION
table below 4 minutes - shave
RATE FOR GROOMING SERVICES AMOUNT
Service User FREE
Paying Service User
Haircut ₱50.00
Shave ₱30.00
95
49. PHYSICAL THERAPY FOR IN-PATIENTS
Description of Service: The Physical Rehabilitation Unit offers physical therapy services for neurologic, orthopedic, and
musculoskeletal disorders. Operating Hours: Monday to Friday, except for holidays; 8:00 am to 5:00 pm (No Noon Break). Contact
number: local 249
OFFICE Activity Therapy Section - Physical Therapy Unit
TYPE OF
TRANSACTION
Physician’s Referral Physician
Consent Form (for pay patient only) Respective ward/pavilion
1. NOD /NAOD forward the 1.1. Receive physician’s referral None 5 minutes Physical Therapist
physician’s referral to the 1.2. Record client’s information (PT Unit)
PT unit
2. For Paying Service 2.1 Receive and verify consent None 5 minutes Nurse I / II
User: Guardian / relative form (Pavilion of Origin)
issues consent form 2.2 Inform PT Unit
2.3 Schedule client for PT Physical Therapist
(PT Unit)
3. Undergo PT procedure 3.1. Initiate Physical Therapy See pricelist 1 hour 30 Physical Therapist
procedure below minutes (PT Unit)
3.2. Accomplish and forward
charge slip to the Billing
Unit (for pay patients only)
Please see
END OF TRANSACTION 1 hour and 40 minutes
table below
CATEGORY AMOUNT
1. In-patient
a. ICU ₱700.00
b. Suite room ₱600.00
c. Private room ₱500.00
d. Ward ₱400.00
e. Charity ₱400.00
2. In-Patient (Psych)
a. Pavilion 6 ₱400.00
b. CRW ₱400.00
₱200.00 (To be
c. Charity shouldered by Malasakit
Center)
96
50. PHYSICAL THERAPY FOR OUT-PATIENTS AND NCMH EMPLOYEES
Description of Service: The Physical Rehabilitation Unit offers physical therapy services for neurologic, orthopedic, and
musculoskeletal disorders. Operating Hours: Monday to Friday, except for holidays; 8:00 am to 5:00 pm (No Noon Break). Contact
number: local 249
OFFICE Activity Therapy Section - Physical Therapy Unit
WHO MAY AVAIL All out-patients and NCMH employees
Physician’s Referral Physician
1. Proceed to Physical 1.1. Receive physician’s referral None 1 minute Physical Therapist
Rehabilitation Unit and 1.2. Issue Client Information (PT Unit)
present physician’s referral Sheet
2. Fill out the Information 2.1 Receive and check None 3 minutes Physical Therapist
Sheet and submit to PT in Information Sheet (PT Unit)
charge 2.2 Issue Charge Slip
3. Proceed to the Collection 3. Process the payment and Php300.00 – 10 minutes Admin Officer III
and Deposit Unit and issue official receipt out-patient (Collection and
provide amount to be paid. Deposit Unit)
If applicable, present Php100.00 -
PWD/Senior Citizen ID for Employee’s
discount dependent
FREE –
NCMH
employee
4. Return to Physical 4. Verify Official Receipt None 1 minute Physical Therapist
Rehabilitation Unit and (PT Unit)
present official receipt
5. Undergo PT procedure 5. Perform PT procedure None 1 hour and 30 Physical Therapist

minutes (PT Unit)
Php300.00 -
Out-patient
Php100.00 -
Employee’s
END OF TRANSACTION 1 hour and 45 minutes
dependent
FREE –
NCMH
employee
97
51. PROCESSING AND ISSUANCE OF HOSPITAL STATISTICAL DATA REQUESTS
FOR RESEARCH PURPOSES
Description of Service: This service involves processing and issuance of Hospital Statistical Data Requests. Operating Hours:
Monday to Friday, except for holidays; 8:00 am to 5:00 pm (No Noon Break).
OFFICE Health Information Management Section (HIMS)
CLASSIFICATION Complex
WHO MAY AVAIL All clients requesting hospital data
Request letter indicating the details of requested data (type of
Client
information, format, coverage, etc.)
Letter of Approval PETRO
1. Proceed to HIMS Pavilion 1.1 Receive request letter and None 10 minutes Admin Officer V
2 and submit request letter letter of approval (HIMS)
and letter of approval to 1.2 Verify authenticity and
HIMS chief validity of documents
1.3 Approve request
2. Proceed to HIMS Main 2.1 Receive request letter and None 6 days Statistician II / III
Office and submit request letter of approval (HIMS)
letter and letter of approval 2.2 Process request
to Health Data Analytics
Unit for processing
3. Receive hospital data files 3. Send de-identified hospital None 10 minutes Statistician II / III
data via client’s preferred (HIMS)
medium (email, hard copy,
etc.)
98
52. PSYCHOLOGICAL ASSESSMENT FOR OUT-PATIENT
Description of Service: The Psychological Section is tasked to administer different psychological examinations that will determine
cognitive and behavioral functioning of a certain individual. Operating Hours: Monday to Friday, except Thursday and holidays;
8:00 am – 5:00 pm (No Noon Break).
OFFICE Psychological Section
TRANSACTION
Out Patients with the following purposes: Diagnostic/Treatment; School and Work Requirement;
WHO MAY AVAIL Court Order to assess competency to stand trial; SSS/GSIS Dependency Claim; PhilHealth/
PCSO/ Medical Financial Assistance/ DSWD Requirement
Psychological Assessment Request form (1) original copy Attending physician (NCMH – OPS)
Charge Slip Psychological Section
1. Present the Psychological 1. Schedule the referred client None 5 minutes Admin Aide III/ IV
Assessment Request Form for assessment Admin Assistant I
(Psychological
Section)
2. On the scheduled day of 2. Verify the name/s on the list None 5 minutes Admin Aide III/ IV
assessment, present the of scheduled examinees, Admin Assistant I
accomplished return slip of and orient the client to the (Psychological
the psychological request testing process Section)
form
3. Undertake battery of 3.1 Administer the battery of None 6 hours Psychologist II
psychological tests and Psychological Tests (Psychological
interview 3.2 Conduct Interview Section)
3.3 Check the completeness of
the examination
3.4 Issue charge slip
4. For paying service user: 4. Process the payment and See pricelist 10 minutes Admin Officer III
Proceed to the Collection issue official receipt below (Collection and
and Deposit Unit and Deposit Unit)
provide amount to be paid
For clients availing Review and verify the 2 hours and 15 Chief, Medical Social
Malasakit Assistance: authenticity of the minutes Service Section and
Proceed to Malasakit requirements presented Malasakit Center
Center and present copy of Operations Manager
Psychological Assessment (Malasakit Center)
Request Form and Charge
Slip for approval
5. For paying service user: 5.1 Record official receipt None Processing of Admin Aide III/ IV
Return to the Psychological number Psychological Admin Assistant I
Section and present official 5.2 Score and interpret the Report is 18 (Psychological
receipt administered working days Section)
For clients availing psychological report
Malasakit Assistance:
99
Return the approved 5.3 Prepare comprehensive
Psychological Assessment psychological reports Psychologist II
Request Form and Charge 5.4 Forward psychological (Psychological
Slip from Malasakit Center reports to HIMS Section)
6. Receive results from the 6. Release Psychological None 5 minutes Admin Aide
Health Information Report (HIMS)
Management Section
(HIMS)
See price
END OF TRANSACTION 19 days
list below
PSYCHOLOGICAL EXAM FEES AMOUNT

Adult Out-patient
1. Assessment ₱1,200.00
2. SSS Requirement ₱950.00
3. Suspected with Intellectual Disability/Other Developmental Concerns ₱1,800.00
4. Fit to Work ₱2,450.00
5. Fit to School (High school level) ₱950.00
6. Fit to School (College level and above) ₱850.00
₱2,500.00
7. For presentation (New Case/Grand Rounds/Staff Conference)
FREE for internal
8. Psychotherapy sessions ₱500.00 per session
9. Drug-Related Case Referrals (For employees who tested positive for
₱2,450.00
drug test)
Child Out-patient
1. Assessment ₱950.00
2. Suspected with Intellectual Disability/Other Concerns ₱1,350.00
3. Fit to School ₱950.00
4. For shelter purposes ₱900.00
₱2,300.00
5. For presentation (New Case/Grand Rounds/Staff Conference)
FREE for internal
6. Psychotherapy sessions ₱500.00 per session
100
53. RELEASING OF BIRTH CERTIFICATE
Description of Service: Processing and releasing of Birth Certificate. Operating Hours: Monday to Friday; 8:00 am – 5:00
pm.
OFFICE Health Information Management Section (HIMS) – Pavilion 2
TYPE OF
TRANSACTION
WHO MAY AVAIL Authorized/ Listed patient’s relative, guardian, and informant
Any valid government issued identification card Respective Issuing Government Agencies/Offices
Notarized authorization (if claimant is not the listed informant
Authorized/Listed relative, guardian or informant
in the patient’s health record)
Registration of Birth Certificate (for common-law/unmarried
Local Civil Registry Office
parents)
1. Proceed to Window 6, 1. Check, verify and validate None 10 minutes Admin Aide
HIMS Pavilion 2 and identification card and Admin Assistant
present any valid authority of the claimant (HIMS)
government issued
identification
card/authorization
2. Check information written 2.1 Assist client in the signing of None 20 minutes Admin Aide
on Birth Certificate and affix the birth certificate Admin Assistant
signature 2.2 For common-law/unmarried (HIMS)
spouses, registration of birth
certificate will be facilitated
by the child’s
parents/authorized
representative
101
54. RELEASING OF CADAVER
Description of Service: Processing and releasing of cadaver to relatives, guardian or informant. Operating Hours: The service
is available 24/7.
OFFICE Health Information Management Section (HIMS) – Pavilion 2
TYPE OF
TRANSACTION
WHO MAY AVAIL Authorized patient’s relative, guardian, informant or representative
Any valid government issued identification card Respective Issuing Government Agencies/Offices
Notarized authorization (if claimant is not the listed informant
Listed relative, guardian or informant
in the patient’s health record)
Funeral Home/Service of choice
1. Proceed to Pavilion 2 1.1 Check, verify and validate None 10 minutes Admin Aide
HIMS (Window 6) and identification and authority of (HIMS)
present any valid the claimant
government issued 1.2 Verify clearance form from
identification pavilion/ward of origin
card/authorization
2. Check information written 2.1 Prepare Disposition of None 10 minutes Admin Aide
on Death Certificate and Cadaver form and secure (HIMS)
sign Disposition of signature from the
Cadaver form authorized claimant
2.2 Inform Laboratory Section
Mortician to assist claimant
3. Proceed to Morgue with the 3. Mortician checks documents None 50 minutes Admin Aide
funeral service for the and facilitates releasing after (Laboratory Section)
claiming of cadaver proper identification of
cadaver by relatives
102
55. REQUEST FOR CORRECTION AND UPDATING OF PATIENT INFORMATION
Description of Service: This service involves the correction/updating of patient information in the HOMIS database. Operating
Hours: Monday to Friday, except for holidays; 8:00 am to 5:00 pm (No Noon Break).
TYPE OF
TRANSACTION
WHO MAY AVAIL All clients requesting correcting / updating of patient information
For change of name and birthdate: Birth Certificate (1) original
Philippine Statistical Authority/ Civil Registry
copy
For change of civil status: Marriage Certificate (1) original copy Philippine Statistical Authority
For change of address: Barangay Certificate of the patient or
any valid Government Issued ID with address, picture and Respective issuing government agencies
signature (1) original copy
If with Representative: Authorization Letter / Photocopy of
Client
Government issued I.D of both client and representative
1. Proceed to the Health 1.1 Verify requestor’s eligibility to None 15 minutes Admin Aide
Information Management request change of information Admin Assistant
Section, window 4A (for 1.2 Change patient information in (HIMS)
Out-patients) or window 6 the HOMIS database
(for In-patients) and fill-up
Correction of Information
request form
103
56. REQUEST TO ACCESS HEALTH RECORDS
Description of Service: This service involves processing requests for access to health records. Operating Hours: Monday
to Friday, except for holidays; 8:00 am to 5:00 pm (No Noon Break).
TYPE OF
TRANSACTION
WHO MAY AVAIL All clients requesting access to patient health records
Health Record Access request form (1) original copy Heath Information Management Section
1. Proceed to HIMS Main 1. Issue Health Record Access None 5 minutes Admin Aide I
Office (for In-patients) or request form (HIMS)
Pavilion 2 HIMS (for Out-
patients) and fill-out the
Health Record Access
Request form
2. Proceed to MCC office or 2.1 Receive and verify the None 15 minutes Admin Officer I
Office of the Authorized request (MCC Office/ Office of
Representative and submit 2.2 Approve request Authorized
the request form for Representative)
approval
3. Proceed to HIMS Main (for 3.1 Receive and verify the None 15 minutes Admin Aide I
In-patients) or Pavilion 2 approved Health Record (HIMS)
HIMS (for Out-patients) and Access request form
submit the approved Health 3.2 Retrieve requested health
Record Access request records
form 3.3 Record borrowed health
record in the monitoring
form
4. Review/ access health 4. Issue borrowed health None 5 minutes Admin. Aide I
record within HIMS office records to client (HIMS)
5. Return health records to 5. Check if health records are None 10 minutes Admin Aide I
authorized HIMS personnel complete and intact (HIMS)
6. Acknowledge end of 6. Assist client in signing the None 5 minutes Admin Aide I
transaction by signing onto Borrowed Health Records (HIMS)
Borrowed Health Records Monitoring Sheet
Monitoring Sheet
104
57. REQUISITION AND ISSUANCE OF MEDICAL RECORDS (IN-PATIENTS)
Description of Service: This service involves processing and issuance of below mentioned health records and services:
1. Medical Abstract
2. Medical Certificate
3. Certificate of Confinement
4. Certified True Copies
5. Photocopying Services
Operating Hours: Monday to Friday, except for holidays; 8:00 am to 5:00 pm (No Noon Break).
TYPE OF
TRANSACTION
WHO MAY AVAIL All clients requesting for above mentioned health records and services for in-patients
For change of name and birthdate:
Birth Certificate (1) original copy Philippine Statistical Authority/ Civil Registry
For change of address: Barangay Certificate of the patient or
any valid Government Issued ID with address, picture and Respective issuing government agencies
signature (1) original copy
Client
1. Proceed to the Health 1.1 Verify requestor’s eligibility None 30 minutes – Admin Aide
Information Management to receive requested Medical abstract Admin Assistant
Section Main Office and fill- documents via interview and / Certificate (HIMS)
up request slip. cross-checking of
requestor’s supporting 15 minutes –
If with representative, documents with HIMS Certificate of
submit Authorization Letter database Confinement /
and photocopy of one (1) 1.2 For request of Medical CTC
valid Government issued ID Abstract / Certificate:
of both the client and Coordinate with and refer
representative. patient to Attending
Physician for approval
1.3 For paying service user:
Issue charge slip and claim
slip indicating the schedule
of release of the needed
documents
2. For request of Medical 2. Process patient’s request None 1 hour Medical Officer
Abstract / Certificate: If and issue requested Medical Specialist
approved, proceed to documents (Respective Pavilion)
Doctor’s office/pavilion for
processing
105
and Deposit Unit and pay Deposit Unit)
required amount
4. Return to Health Information 4.1 Verify official receipt and None 5 minutes Admin Aide
Management Section Main claim slip Admin Assistant
Office and present official 4.2 Check availability of (HIMS)
receipt and claim slip requested document
4.3 Issue requested document
1 hour and 45 minutes – Medical
See Abstract / Certificate
END OF TRANSACTION pricelist
below 30 minutes – Certificate of
Confinement / CTC
CERTIFICATES AND ABSTRACT AMENDED RATES

1. Medical Abstract
a. Pay Free of Charge
b. Service (Classified as C1, C2, C3 and D) Free of Charge
c. For Foreign use ₱300.00
2. Medical Certificate
3. Certificates of Confinement / Consultation
c. For Foreign use ₱300.00
4. Certified True Copies (per page)
b. Service Free of Charge
5. Retrieval of Records and Photocopying services (per page)
b. Service Free of Charge
Note: To improve and accommodate our patients' requests for the issuance of Medical certificates/Clinical abstracts, we
would like to inform our clients that starting April 25, 2022, all the requests made on Monday, Tuesday, Wednesday, and
Friday, from 8:00 am to 12:00 noon will be released within the same day, however, requests made beyond 12:00 noon will
be issued on the following day.
106
58. REQUISITION AND ISSUANCE OF MEDICAL RECORDS (OUT-PATIENTS)
Description of Service: This service involves processing and issuance of Certificates of Confinement / Consultation, Certified
True Copies, Photocopying Services, and Patient’s ID. Operating Hours: Monday to Friday, except for holidays; 8:00 am to
5:00 pm (No Noon Break).
TYPE OF
TRANSACTION
WHO MAY AVAIL All clients requesting for above mentioned health records and services for out-patients
For change of name and birthdate: Birth Certificate (1) original
Philippine Statistical Authority/ Civil Registry
copy
For change of address: Original Barangay Certificate of the
patient or any valid Government Issued ID with address, Respective issuing government agencies
picture and signature
Client
1. Proceed to the Health 1.1 Verify requestor’s eligibility None 15 minutes HIMS Personnel
Information Management to receive requested (HIMS)
Section (Window 5) and fill- documents via interview and
up Request Slip cross-checking of
requestor’s supporting
If with representative, documents with HIMS
submit Authorization Letter database
and photocopy of one (1) 1.2 For paying service user:
valid Government issued ID Issue charge slip and claim
of both the client and slip indicating the schedule
representative of release of the needed
documents
and Deposit Unit and pay Deposit Unit)
required amount
3. Return to Window 5 and 3.1 Verify official receipt and None 5 minutes HIMS Personnel
present official receipt and claim slip (HIMS)
claim slip 3.2 Issue requested document
See
END OF TRANSACTION pricelist 30 minutes
below
107
CERTIFICATES AND ABSTRACT AMENDED RATES

Certificates of Confinement / Consultation
Pay Free of Charge
Service (Classified as C1, C2, C3 and D) Free of Charge
For Foreign use ₱300.00
Certified True Copies (per page)
Pay Free of Charge
Service Free of Charge
Retrieval of Records and Photocopying services (per page)
Pay Free of Charge
Service Free of Charge
Patient’s ID Free of Charge
Note: To improve and accommodate our patients' requests for the issuance of Medical certificates/Clinical abstracts, we
would like to inform our clients that starting April 25, 2022, all the requests made on Monday, Tuesday, Wednesday, and
Friday, from 8:00 am to 12:00 noon will be released within the same day, however, requests made beyond 12:00 noon will
be issued on the following day.
108
59. RESPIRATORY THERAPY SERVICES
Description of Service: The Activity Therapy Section - Respiratory Therapy Unit is responsible for rendering respiratory
procedures/services, namely: Aerosol Therapy, Arterial Blood Gas Extraction and Sampling, Chest Physiotherapy, Incentive
Spirometry, Mechanical Ventilator, High Flow O2 System, BiPAP (Non-Invasive Ventilator), and Sputum Induction.
OFFICE Activity Therapy Section – Respiratory Therapy Unit
TYPE OF
TRANSACTION
Respiratory Request Form Pavilion of origin / Respiratory Therapy Unit
1. Call ATS at local 384 for 1. Receive request of None 5 minutes RT I / II / III
the request procedure (ATS-Respiratory
Therapy Unit)
2. Wait for the Respiratory 2.1 Proceed to the pavilion and None Refer to Total RT I / II / III
Therapist on duty in your verify the order on the Processing (ATS-Respiratory
area for the initiation of the patient’s chart Time Table Therapy Unit)
requested procedure 2.2 Inform the patient’s relatives below
(if any) of the procedure
2.3 Perform the procedure
For Sputum Induction:

Collect sputum in ample
amount and endorse
specimen to the Nurse on
duty, for submission to the
Laboratory Section
2.4 Record patient assessment

before and after the
treatment on the patient’s
monitoring form
2.5 Notify the Nurse on duty
once procedure is done
below
TOTAL PROCESSING TIME PROCEDURE
15 minutes Arterial Blood Gas Extraction and Sampling

Aerosol Therapy
25 minutes Chest Physiotherapy
Incentive Spirometry
30 minutes Sputum Induction
Mechanical Ventilator, High Flow O2 System, BiPAP
50 minutes (Non-Invasive Ventilator)
109
60. SPIRITUAL CARE SERVICES
Description of Service: The Spiritual Care Unit is one of the units under the Activity Therapy Section. Its main task is to perform
spiritual services as scheduled or requested by clients. Operating Hours: Monday to Friday, except for holidays; 8:00 am to 5:00
pm (No Noon Break) Contact Number: 85319001 loc. 384
OFFICE Activity Therapy Section
WHO MAY AVAIL All NCMH employees and in-patients
Request form Activity Therapy Section
1. Make a request through 1. Receive request and notify None 2 minutes Admin Aide I
phone call or by the hospital chaplain to (ATS)
accomplishing a request determine his availability
form
Services Available:
▪ Holy Mass
▪ Confession
▪ Anointing of the sick
▪ Blessing
2. Wait for the approval of the 2. Notify the client of the None 2 minutes Admin Aide I
schedule by the hospital approval status of the (ATS)
chaplain request
3. Prepare the patient / office 3. The hospital chaplain None 1 hour and 30 Hospital Chaplain
who / that will receive the performs the requested minutes (ATS)
service services
110
61. X-RAY AND ULTRASOUND SERVICES
Description of Service: The Radiology Section provides a comprehensive diagnostic imaging service to all clients. Operating
Hours: The x-ray service is available 24/7; The ultrasound service is available from Monday to Friday, 8:00 am – 5:00 pm.
Emergency procedure may be done beyond office hours including weekends and holidays but must be coordinated with radiology
staff.
OFFICE Radiology Section
Radiology Request Form (1) original copy Out Patient Section
Charge Slip Radiology Section
Patient Chart – for in-patient only Pavilion of Origin
Valid Government-Issued ID (1) original copy Respective issuing government agencies
Authorization Letter (if applicable) Client
1. For In-Patient: The 1.1. Receive Radiology Request None 2 minutes Radiologic
Nursing Attendant presents Form for verification Technologist
the Radiology request form 1.2. Explain the procedures and Admin Aide
with the patient chart at the fees and issue charge slip (Radiology Section)
Radiology Section receiving 1.3. Return verified Radiology
window Request Form for clients
availing endowment thru
For Out-Patient and Malasakit Center
NCMH Employees:
Present Radiology request
form
2. Out-Patient and NCMH 2. New Client: Verify client’s None 10 minutes Admin Aide I
Employees: Proceed to name and encode (HIMS)
HIMS for the Hospital Sociological Data Sheet
Number
a. New Client: Old Client: Verify client’s
Accomplish Sociological information
Data Sheet
b. Old Client: Present
Valid I.D
Paying Service User: Paying Service User: Refer to list 10 minutes Admin Officer III
Proceed to Collection and Process the payment and of fees (Collection and
Deposit Unit and provide issue Official Receipt below Deposit Unit)
amount to be paid
Clients availing Malasakit Clients availing Malasakit None 2 hours and 15 Chief, Medical Social
Assistance: Assistance: Assess for minutes Service Section and
Proceed to Malasakit eligibility of endowment Malasakit Center
Center and present charge (Refer to Malasakit Center Operations Manager
slip and radiology request Medical Assistance (Malasakit Center)
form Procedure)
111
3. Return to the Radiology 3. Verify the official receipt and None 2 minutes Radiologic
Section and present official Charge Slip Technologist
receipt/ Radiology Request Admin Aide
Form and Charge Slip (Radiology Section)
verified by Malasakit Center
4. Proceed to the 4.1 Verify client’s identity None 30 minutes Radiologic

radiographic/ ultrasound 4.2 Execute the desired Technologist
room procedure (Radiology Section)
5. Receive result after 2 5. Issue result after 2 working None 2 minutes Radiologic
working days days Technologist
Official result (Radiology Section)
For In-Patient: The For In-Patient: The will be issued
receiving medical official result will be after two (2) Admin Aide
personnel writes his / her delivered to the working days (Radiology Section)
name and signs in the respective pavilion
releasing folder
For Out-Patient and

Employee: Present valid
I.D
2 days, 46 minutes –
Refer to Paying Service user
fees below 2 days, 2 hours, and 51 minutes –
Malasakit Center Client
112
LIST OF FEES FOR X-RAY AND ULTRASOUND SERVICES
FEE READER’S FEE READER’ FEE READER’S
PROCEDURE PROCEDURE S FEE PROCEDURE
(Php) FEE (Php) (Php) (Php) (Php) FEE (Php)
Intravenous Pyelography
X-RAY PROCEDURES Temporo Mandibular Joint 600.00 120.00 1,450.00 300.00
(IVP)
ABDOMEN Mastoid Series 600.00 100.00 Small Bowel Series 1,550.00 300.00
Abdomen Plain/ KUB 550.00 110.00 Nasal Bone (Soft Tissue Lateral) 400.00 100.00 T - Tube Cholangiogram 1,000.00 300.00
Abdomen (Cross-Table Upper Gastrointestinal
550.00 110.00 Orbits (Waters, Rhese) 550.00 100.00 1,800.00 360.00
Lateral) Series
Abdomen (Upright/Supine) 550.00 110.00 Paranasal Sinuses 600.00 100.00 C-arm procedures 3,000.00
Abdomen Portable 550.00 110.00 Skull Series (AP, Lateral, Towne's) 500.00 100.00 ULTRASOUND PROCEDURES
One (1) Organ (Single
CHEST Skull AP, Lateral 400.00 100.00 600.00 200.00
organ)
Chest PA 350.00 100.00 Zygoma 350.00 100.00 Thyroid Gland 800.00 300.00
Chest PA Lateral 600.00 100.00 VERTEBRAL COLUMN Neck 1,500.00 500.00
Chest Lateral Decubitus 350.00 100.00 Neck, Soft Tissue (AP, Lateral) 350.00 100.00 Hemithorax/ Chest 600.00 200.00
Hemithorax/ Chest with
Chest Apico Lodotic view 250.00 100.00 Cervical Spine (AP, Lateral) 350.00 100.00 600.00 200.00
marking
Cervical Spine (AP, Lateral,
Chest (Spot view) 250.00 100.00 600.00 100.00 Soft Tissue 700.00 200.00
Oblique)
Chest Portable 700.00 100.00 Thoracic Spine (AP, Lateral) 850.00 150.00 Kidneys 800.00 200.00
Kidneys-Ureter-Bladder
UPPER EXTREMITIES Thoracic Cage/ Rib Cage (AP/PA) 350.00 100.00 950.00 200.00
(KUB)
Thoracic Cage/ Rib Cage Kidneys-Ureter-Bladder
Clavicle 300.00 100.00 600.00 100.00 950.00 200.00
(Oblique) (KUB) + Prostate
Thoraco - Lumbar Spine (AP,
Scapula 400.00 100.00 850.00 150.00 Hepatobillary Tree 900.00 200.00
Lateral)
Shoulder joint 350.00 100.00 Lumbo - Sacral Spine (AP, Lateral) 480.00 100.00 Upper Abdomen 1,000.00 250.00
Lumbo - Sacral Spine (AP, Lateral,
Humerus/ Arm 400.00 100.00 800.00 100.00 Lower Abdomen 1,000.00 200.00
Both Oblique)
Elbow joint 300.00 100.00 Pelvis 400.00 100.00 Whole Abdomen 1,700.00 350.00
Pelvis (Transabdominal
Radius Ulna/ Forearm 350.00 100.00 Sacrum/ Coccyx 250.00 100.00 850.00 200.00
Sonography)
Wrist joint 350.00 100.00 Scoliosis Series 1,200.00 240.00 Biophysical Score 850.00 250.00
Hand PA, Lateral, Oblique 350.00 100.00 Skeletal Survey 3,100.00 500.00 Transvaginal 850.00 300.00
LOWER EXTREMITIES Bone Aging (Adolescents) 800.00 100.00 Transrectal 900.00 300.00
Prostate (Trans-
Hip AP 400.00 100.00 Babygram (Neonates) 900.00 200.00 800.00 200.00
Abdominal approach)
Prostate (Transrectal
Femur/ Thigh AP, Lateral 400.00 100.00 X-RAY SPECIAL PROCEDURE 1,000.00 300.00
approach)
Knee joint AP, Lateral 400.00 100.00 Barium Enema 1,800.00 350.00 Inguino Scrotal 900.00 300.00
Ultrasound -Guided
Tibia Fibula/ Leg AP, Lateral 400.00 100.00 Cystogram 1,150.00 220.00 1,800.00 1,000.00
Thoracentecis
Ultrasound-Guided
Ankle joint AP, Lateral 330.00 100.00 Cystourethrogram/ Urethrogram 1,200.00 240.00 1,800.00 1,000.00
Paracentesis
Ultrasound-Guided
Ankle AP, Lateral, Mortise 600.00 100.00 Distal Colonogram 1,500.00 250.00 2,000.00 1,000.00
Aspiration Biopsy
Ultrasound-Guided
Calcaneus 400.00 100.00 Esophogram 800.00 150.00 2,000.00 1,000.00
Suprapubic Tap
Ultrasound-Guided IJ
Foot AP, Lateral, Oblique 400.00 100.00 Fistulogram 1,550.00 300.00 1,000.00 1,000.00
catheter insertion
HEAD Hysterosalpingogram 1,500.00 300.00 Breast Ultrasound 1,000.00 300.00
Mandible 550.00 100.00 Intra - Operative Cholangiogram 1,450.00 300.00 Cranial Ultrasound 950.00 500.00
Focused Assessment
with Sonography in 1,000.00 300.00
NOTE: Sedation, Contrast Media (DYE) and other Supplies are not included in the procedure.
Trauma
Abdominal Aorta 620.00 200.00
113
62. HIRING PROCESS
Description of Service: A guide for all applicants on the Hiring Process. Operating Hours: Monday to Friday, except for holidays;
8:00 am – 5:00 pm.
OFFICE Human Resource Management Office
TYPE OF
TRANSACTION
WHO MAY AVAIL All individuals who want to apply at NCMH
Application letter addressed to the Medical Center Chief II thru
Applicant
Chief, HRMO (1) original copy
Resume/ CV with passport-sized ID picture (1) original copy Applicant
Downloadable Form
Duly accomplished Personal Data Sheet (PDS) (1) original copy https://ncmh.gov.ph/index.php/issuances-downloadable-
forms#hrmo-forms
Autobiography (1) original copy Applicant
College/High School diploma (1) photocopy Respective university, school
Transcript of Records (1) photocopy Respective university, school
Training Certificates (1) photocopy each Respective training organizer
Employment Certificates (1) photocopy each Respective employer
NBI Clearance (1) photocopy National Bureau of Investigation
Birth Certificate (1) photocopy Philippine Statistics Office
Certificate of Eligibility (if applicable) (1) photocopy Civil Service Commission
Certified true copy of Board Rating (1) original copy Professional Regulatory Commission
Certified true copy of PRC License (1) original copy Professional Regulatory Commission
Performance Rating of 2 rating periods (for gov’t employees) (1)
Respective government agency
photocopy
Vaccination Card/Booster Shot (1) photocopy Applicant
PROCESSING PERSON
CLIENT STEP AGENCY ACTION FEES TO BE PAID
TIME RESPONSIBLE
1. Submit complete set of 1.1 Receive and check None 10 minutes Admin Assistant I / II
documents to the HRMO documents (Recruitment Unit,
1.2 Issue Applicant HRMO)
Monitoring Form
2. Review and Sign the 2. Schedule applicants for None 1 day Admin Assistant I / II
Applicants Monitoring technical exam (Recruitment Unit,
Form HRMO)
3. Return on the day of 3.1 Conduct technical exam None 2 days Admin Assistant I / II
schedule and undergo 3.2 Issue Background (Recruitment Unit,
technical exam Investigation Form (BIF shall be HRMO)
accomplished
within 5 working
days)
114
4. Submit the 4.1 Receive and check the None 1 day Admin Assistant I / II
accomplished completeness of (Recruitment Unit,
Background information HRMO)
Investigation Form 4.2 Schedule applicant for
Neuro-Psychiatric Exam
5. Secure referral slip and 5.1 Issue the referral slip for Refer to schedule 3 minutes Admin Assistant I / II
accomplish the Neuro- the Neuro-Psychiatric of fees below (Recruitment Unit,
Psychiatric exam exam (NP Screening HRMO)
(Refer to result will be
Neuropsychiatric released after
Assessment and 14 working
Psychological Testing days)
procedure)
5.2 Prepare the comparative 5 working days
reports
5.3 Schedule applicant for 1 day
panel interview
6. Attend the Panel 6. Conduct panel interview None 1 day President of

Interview NACEMHEA
Chief, HRMO
Chief of Finance
OIC, CMPS-
Community Service
CMPS-Hospital
Service
Chief PETRO
PAI Representative
Chief, HOPSS
7. Receive notification 7. Notify applicant about the None 7 working days Admin Assistant I, II
result (Recruitment Unit,
HRMO)
Refer to schedule
END OF TRANSACTION 38 days and 13 minutes
of fees below
List of Fees for Neuro-Psychiatric Exam

Applicants Current Price
Rank and file (SG 9 and Below) FREE
Rank and file (SG 10-17) FREE
Supervisory (SG 18-21) Php 1,900.00
Managerial (SG 22 and Above) Php 2,160.00
Nursing Attendant and Others (SG 9 and Below) FREE
Nurse I (SG 15) FREE
Nurse II (SG 16-for Promotion) Php 1,900.00
Medical Officer III and IV (SG 18-20; entry) Php 1,900.00
Medical Specialist and Other Managerial Positions (SG 22 and Above; Entry or Promotion Php 2,160.00
115
63. PROCUREMENT OF GOODS, INFRASTRUCTURE AND
CONSULTING SERVICES
Description of Service: The Procurement Section through the NCMH-Bids and Awards Committee ensures an on-time, in full and
without error procurement process in accordance with the Republic Act 9184 and its Revised Implementing Rules and Regulations.
OFFICE Procurement Section
TYPE OF
CLASSIFICATION Highly Technical G2B – Government to Business
TRANSACTION
WHO MAY AVAIL All qualified and eligible bidders
Order of Payment Procurement Section
Bidding Documents Procurement Section
Requirements to be submitted by the bidder:
(see Annex A)
1. Check/view PhilGEPS 1. Post requirements and None 5 minutes Admin Assistant I/II/III
posting for list of bidding schedule in Admin Aide III/IV
requirements and schedule PhilGEPS website and (Procurement Section)
of bidding activities bulletin board
2. Purchase bidding 2. Issue Order of Payment None 5 minutes Admin Assistant I/II/III
documents Admin Aide III/IV
(Procurement Section)
3. Proceed to Collection and 3. Process the payment and Standard 10 minutes Administrative Officer
Deposit Unit and pay issue an official receipt rate based III (Collection and
required amount on R.A 9184 Deposit Unit)
4. Proceed to Procurement 4. Receive / check official None 10 minutes Admin Assistant I/II/III
section and submit official receipt and provide set of Admin Aide III/IV
receipt bidding documents (Procurement Section)
5. Participate in the Public 5. Conducts Public Bidding None 6 hours Admin Officer I/V
Bidding Activities Activities Admin Assistant I/II/III
Admin Aide III/IV
(Procurement Section)
Issuance/Awarding
Process:
6. Receive Notices from the 6. Issue Notices and Awarding None Minimum of 28 Admin Officer I/V
BAC Secretariat: of Contracts to 136 Calendar Admin Assistant I/II/III
a. Notice of Eligibility / Days for Goods, Admin Aide III/IV
Ineligibility 156 Calendar (Procurement Section)
116
b. Notice of Post Days for
Qualification / Post Infrastructure,
Disqualification and 180
c. Notice of Award Calendar for
(NOA) Services
Note: Upon receipt of
NOA, compliance to
Performance Security
Bond and Contract
Agreement Form
requirements
d. Purchase Order /
Contract Agreement
e. Notice to Proceed
(NTP)
Minimum of 28 to 136 Calendar Days
for Goods
Standard
END OF TRANSACTION rate based 156 Calendar Days for Infrastructure
on R.A 9184
180 Calendar Days for Services
(R.A 9184)
117
Annex A
CHECKLIST FOR BIDDERS
(GOODS)
Project:
Approved Budget for the Contract (ABC):
Date/Time and Venue of Opening of Bids:
Instructions:
1. A bidder must submit one (1) original (i.e., “ORIGINAL”) during Submission and Opening of Bids. All documents
shall be current and updated.
2. The “ORIGINAL” copy of the bid form shall be typed or written in ink and shall be signed by the bidder or its duly
authorized representative each and every page.
3. To facilitate the evaluation of the bids, bidders are advised to compile the documents in two (2) separate folders (i.e.,
one for Eligibility/Technical Documents and another for Financial Documents), properly labeled and tabbed, and
following the sequence provided herein.
Note: Technical and Eligibility Documents are based on GPPB Resolution No. 16-2020
CHECKLIST OF TECHNICAL AND FINANCIAL DOCUMENT’S ENVELOPE
TECHNICAL COMPONENT ENVELOPE

CLASS “A” DOCUMENTS
A. LEGAL DOCUMENTS
1. Valid PhilGEPS Registration Certificate (Platinum Membership) (all pages); or
2. Registration certificate from Securities and Exchange Commission (SEC), Department of Trade
and Industry (DTI) for sole proprietorship, or Cooperative Development Authority (CDA) for
cooperatives or its equivalent document, and
3. Mayor’s or Business permit issued by the city or municipality where the principal place of
business of the prospective bidder is located, or the equivalent document for Exclusive Economic
Zones or Areas; and
4. Tax clearance per E.O. No. 398, s. 2005, as finally reviewed and approved by the Bureau of
Internal Revenue (BIR).
B. TECHNICAL DOCUMENTS
5. Statement of the prospective bidder of all its ongoing government and private contracts, including
contracts awarded but not yet started, if any, whether similar or not similar in nature and
complexity to the contracts to be bid; and
6. Statement of the bidder’s Single Largest Completed Contract (SLCC) similar to the contract to be
bid, except under conditions provided for in Sections 23.4.1.3 and 23.4.2.4 of the 2016 revised
IRR of RA No. 9184, within the relevant period as provided in the Bidding Documents; and
NOTE: Similar project refers to “the same project to be bid”, costing at least twenty five per cent
(25%) of the ABC.
*All spaces should be filled up with correct information.
7. Original Copy of Bid Security. If in the form of a Surety Bond, submit also a certification issued by
the Insurance Commission; Or Original copy of Notarized Bid Securing Declaration; and
7.1 Notarized Bid Securing Declaration, using the form prescribed in Annex: Bidding
Forms; or
7.2 Cash, Cashier’s/Manager’s Check, issued by a Universal or Commercial Bank (not
less than 2% of the ABC); or
118
7.3 Bank Draft/Guarantee or an irrevocable Letter of Credit issued by a Universal or
Commercial Bank, or by a foreign bank but shall be accompanied by a confirmation
from a Universal or Commercial Bank(not less than 2% of the ABC) ; or
7.4 Surety Bond, callable upon demand [issued by a surety or insurance company, with a
certification from the Insurance Commission as authorized to issue such instrument] (not
less than 5% of the ABC).
8. Conformity with the Technical Specifications, which may include production/delivery schedule,
manpower requirements, and/or after-sales/parts, if applicable; and
9. Original duly signed Omnibus Sworn Statement (OSS); And if applicable, Original Notarized
Secretary’s Certificate in case of a corporation, partnership, or cooperative; or Original Special
Power of Attorney of all members of the joint venture giving full power and authority to its officer
to sign the OSS and do acts to represent the Bidder.
C. FINANCIAL DOCUMENTS
10. The Supplier’s audited financial statements, showing, among others, the Supplier’s total and
current assets and liabilities, stamped “received” by the BIR or its duly accredited and authorized
institutions, for the preceding calendar year which should not be earlier than two (2) years from
date of bid submission; and
11. The prospective bidder’s computation of Net Financial Contracting Capacity (NFCC); Or A
committed Line of Credit from a Universal or Commercial Bank in lieu of its NFCC computation.
CLASS “B” DOCUMENTS IF APPLICABLE
12. If applicable, a duly signed joint venture agreement (JVA) in case the joint venture is already in
existence; Or Duly notarized statements from all the potential join venture partners stating that they
will enter into and abide by the provisions of the JVA in the instance that the bid is successful.
****IF NOT APPLICABLE INDICATE IN A SEPARATE SHEET WITH TABBING THAT JOINT
VENTURE AGREEMENT IS NOT APPLICABLE****
OTHER DOCUMENTARY REQUIREMENTS UNDER RA NO. 9184 (as applicable)
FINANCIAL COMPONENT ENVELOPE
(a) Original of duly signed and accomplished Financial Bid Form; and
(b) Original of duly signed and accomplished Price Schedule(s)
Note well:
1. Any missing, incomplete, or patently insufficient document in the above-mentioned checklist shall be considered
“FAILED” (as per Rule IX, Sec. 30.1 of R.A. No. 9184).
2. In case of discrepancies between this checklist and the bidding documents the latter shall prevail.
The above checklist was discussed and agreed upon by the members of the NCMH Bids and Awards Committee in
consultation with its Technical Working Group, including the proponent /end-user/ implementing unit.
119
(INFRASTRUCTURE AND EQUIPMENT)
Project:
Instructions:
1. A bidder must submit one (1) original (i.e., “ORIGINAL”) DURING SUBMISSION AND OPENING OF BIDS and two
(2) additional copies of the original (i.e., “COPY NO. 1” and “COPY NO. 2” DURING POST QUALIFICATION (AS
ADDITIONAL REQUIREMENTS). All documents shall be current and updated.
authorized representative each and every page.
one for Eligibility/Technical Documents and another for Financial Documents), properly labelled and tabbed, and
Note: Technical and Eligibility Documents are based on GPPB Resolution No. 16-2020

A. LEGAL DOCUMENTS
1. REGISTRATION CERTIFICATE FROM PHILIPPINE GOVERNMENT ELECTRONIC
PROCUREMENT SYSTEM (PHILGEPS) – Platinum Membership; or
2. BUSINESS REGISTRATION CERTIFICATE from the Securities and Exchange Commission
(SEC, Department of Trade and Industry (DTI) for sole proprietorship, or Cooperative Development
Authority (CDA) for cooperatives, or any proof of such registration as stated in the BDS; and e
3. MAYOR’S PERMIT (valid and current) issued by the city of municipality where the principal place
of business of the prospective bidder is located; and
4. TAX CLEARANCE CERTIFICATE (valid and current) for Bidding Purposes, per Executive Order
No. 398, s. 2005, as finally reviewed and approved by BIR.
1. Statement of ALL ITS ON-GOING GOVERNMENT AND PRIVATE CONTRACTS*, including
contracts awarded but not yet started, if any, whether similar or not similar in nature and complexity
to the contract to be bid, using the form prescribed in Annex: Bidding Forms; and This statement
shall be supported with: Notice of Award or Notice to Proceed or Contract issued by the owners.
2. Statement of the Bidder’s SINGLE LARGEST COMPLETED CONTRACT (SLCC)* similar to the
contract to be bid, in accordance with ITB Clause 5.4 and using the form prescribed in Annex:
Bidding Forms.
Note: Similar project refers to “the same project to be bid”, costing at least fifty percent (50%) of the ABC.
This statement shall be supported with:
a. Notice of Award or Contract issued by the owners.
b. Project Owner’s Certificate of Final Acceptance, or the Certificate of Completion, which must
be at least satisfactory. In case of contracts with the private sector, an equivalent document shall be
submitted.
120
3. Valid Philippine Contractor’s Accreditation Board (PCAB) License and Registration (At least
Category C & D) or;
4. Valid Special PCAB License in case of Joint Ventures; and
5. Registration for the type and cost of the contract to be bid
6. BID SECURITY in any of the following form:
6.1 Notarized Bid Securing Declaration, using the form prescribed in Annex: Bidding Forms; or
6.2 Cash, Cashier’s / Manager’s Check, issued by a Universal or Commercial Bank (not less
than 2% of the ABC); or
6.3 Bank Draft / Guarantee or an irrevocable Letter of Credit issued by a Universal or
Commercial Bank, or by a foreign bank but shall be accompanied by a confirmation from a
Universal or Commercial Bank (not less than 2% of the ABC); or
certification from the Insurance Commission as authorized to issue such instrument] (not less
than 5% of the ABC).
7. PROJECT REQUIREMENTS, which shall include the following:
7.1 Organizational Chart for the contract to be bid;
7.2 List of Contractor’s key Personnel (viz, Project Manager, Project Engineers, Materials
Engineer, and Foremen), to be assigned to the contract to be bid, with their complete
qualification and experience data;
7.3 List of Contractor’s major equipment units, which are owned, leased, and / or under
purchase agreements, supported by proof of ownership or certification of availability of
equipment from the equipment lessor / vendor for the duration of the project, as the case
may be.
8. Notarized OMNIBUS SWORN STATEMENT in accordance with Section 25.3 of the IRR of RA
9184, using the form prescribed in Annex: Bidding Forms.
9. AUTHORITY OF THE SIGNATORY, whichever is applicable:
a. Special Power of Attorney, in case of Single Proprietorship.
b. Resolution from the General Manager or President, if Partnership.
c. Board resolution with Secretary’s Certificate, in case of Corporation.
d. Resolution signed by all the joint-venture partners, if case of Joint-Venture.
FINANCIAL DOCUMENTS
10. AUDITED FINANCIAL STATEMENTS (for CY2018 and 2019) showing among others the total
and current assets and liabilities stamped “received” by the BIR or its duly accredited and
authorized institutions for the preceding calendar year which should not be earlier than two (2)
years from date of submission. Attached a copy of the latest Annual Income or Business Tax
Returns filed and paid thru BIR’s Electronic Filing and Payment Systems (eFPS).
11. Duly signed NET FINANCIAL CONTRACTING CAPACITY (NFCC) COMPUTATION, in
accordance with ITB Clause 5.5, or a commitment from a Universal or Commercial Bank to extend
a Credit Line in favor of the prospective bidder if awarded the contract to be bid.
CLASS “B” DOCUMENTS: IF APPLICABLE

12. JOINT VENTURE AGREEMENT (JVA), in case the joint venture is already in existence;
or In the absence of a JVA Duly Notarized Statements (i.e., Protocol / Undertaking of Agreement)
from all the potential joint venture partners should be included in the bid, stating: That, they will
enter into and abide by the provisions of the JVA in the event that the bid is successful; and That,
failure to enter into a joint venture in the event of a contract award shall be ground for the forfeiture
of the bid security (Section 23.1 (b) of the 2016 Revised IRR).
121
Notes:
a. The JVA or the Protocol must specify the company / partner and the name of the office designated as
the authorized representative of the joint venture.
b. Each partner of the joint venture shall submit their respective Legal (I.A) – Eligibility Documents.
c. The submission of technical and financial eligibility documents by any of the joint venture partners
constitutes compliance: Provided that, the partner responsible to submit the NFCC shall likewise submit
the Statement of all its ongoing contracts and latest Audited Financial Statements.
****IF NOT APPLICABLE INDICATE IN A SEPARATE SHEET WITH TABBING THAT JOINT VENTURE
AGREEMENT IS NOT APPLICABLE****

1. Original of Duly signed and accomplished FINANCIAL BID FORM. And
2. Original of duly signed Bid Price in the Bill of Quantities; and
3. Duly accomplished Detailed Estimates Form, including a summary sheet indicating the unit prices of
construction materials, labor rates, and equipment rental used in coming up with the Bid; and
4. Cash Flow by Quarter
Note well:
1. Any missing, incomplete, or patently insufficient document in the above-mentioned checklist shall be
considered “FAILED” (as per Rule IX, Sec. 30.1 of R.A. No. 9184).
122
(CONTRACT SERVICES AND CONSULTING SERVICES)
Project:
Instructions:
1. A bidder must submit one (1) original during submission and opening of bids and two (2) additional copies of the
original are requested to be submitted on the submission of the additional requirements for post qualification. All
documents shall be current and updated.
authorized representative.
one for Eligibility/Technical Documents and another for Financial Documents), properly labelled and tabbed, and

A. LEGAL DOCUMENTS
1. REGISTRATION CERTIFICATE FROM PHILIPPINE GOVERNMENT ELECTRONIC
PROCUREMENT SYSTEM (PHILGEPS) – Platinum Membership; or
2. BUSINESS REGISTRATION CERTIFICATE from the Securities and Exchange Commission
(SEC, Department of Trade and Industry (DTI) for sole proprietorship, or Cooperative Development
Authority (CDA) for cooperatives, or any proof of such registration as stated in the BDS; and e
3. MAYOR’S PERMIT (valid and current) issued by the city of municipality where the principal place
of business of the prospective bidder is located; and
4. TAX CLEARANCE CERTIFICATE (valid and current) for Bidding Purposes, per Executive Order
No. 398, s. 2005, as finally reviewed and approved by BIR.
1. Statement of ALL ITS ON-GOING GOVERNMENT AND PRIVATE CONTRACTS*, including
contracts awarded but not yet started, if any, whether similar or not similar in nature and complexity
to the contract to be bid, using the form prescribed in Annex: Bidding Forms; and This statement
shall be supported with: Notice of Award or Notice to Proceed or Contract issued by the owners.
2. Statement of the Bidder’s SINGLE LARGEST COMPLETED CONTRACT (SLCC)* similar to the
contract to be bid, in accordance with ITB Clause 5.4 and using the form prescribed in Annex:
Bidding Forms.
Note: Similar project refers to “the same project to be bid”, costing at least fifty percent (50%) of the ABC.
This statement shall be supported with:
c. Notice of Award or Contract issued by the owners.
d. Project Owner’s Certificate of Final Acceptance, or the Certificate of Completion, which must
be at least satisfactory. In case of contracts with the private sector, an equivalent document shall be
submitted.
123
3. BID SECURITY in any of the following form:
3.1 Notarized Bid Securing Declaration, using the form prescribed in Annex: Bidding Forms;
or
3.2 Cash, Cashier’s/Manager’s Check, issued by a Universal or Commercial Bank (not less
than 2% of the ABC); or
3.3 Bank Draft/Guarantee or an irrevocable Letter of Credit issued by a Universal or
Commercial Bank, or by a foreign bank but shall be accompanied by a confirmation from a
Universal or Commercial Bank(not less than 2% of the ABC); or
certification from the Insurance Commission as authorized to issue such instrument](not less
than 5% of the ABC).
4. Conformity to TECHNICAL SPECIFICATIONS, using the prescribed form in Section VII of the
Bidding Documents and showing compliance to each item description provided for by NCMH;
5. Notarized OMNIBUS SWORN STATEMENT in accordance with Section 25.3 of the IRR of RA
9184, using the form prescribed in Annex: Bidding Forms.
6. AUTHORITY OF THE SIGNATORY, whichever is applicable:
a. Special Power of Attorney, in case of single proprietorship.
b. Resolution from the General Manager or President, if partnership.
c. Board resolution with Secretary’s Certificate, in case of Corporation.
d. Resolution signed by all the joint-venture partners, in case of Joint-Venture.
C. FINANCIAL DOCUMENTS
7. The Supplier’s AUDITED FINANCIAL STATEMENTS, showing among others the total and
current assets and liabilities stamped “received” by the BIR or its duly accredited and authorized
institutions for the preceding calendar year which should not be earlier than two (2) years from date
of bid submission. (CY 2019 with comparative statement CY 2019 and CY 2018)
8. Duly signed NET FINANCIAL CONTRACTING CAPACITY (NFCC) COMPUTATION, in
accordance with ITB Clause 5.5, or a commitment from a Universal or Commercial Bank to extend
a Credit Line in favor of the prospective bidder if awarded the contract to be bid
CLASS B DOCUMENTS IF APPLICABLE
9. JOINT VENTURE AGREEMENT (JVA),in case the joint venture is already in existence; or In the
absence of a JVA, Duly Notarized Statements (i.e., Protocol/Undertaking of Agreement) from all
the potential joint venture partners should be included in the bid, stating: That, they will enter into
and abide by the provisions of the JVA in the event that the bid is successful; and That, failure to
enter into a joint venture in the event of a contract award shall be ground for the forfeiture of the
bid security (Section 23.1(b) of the 2016 Revised IRR).
NOTES:
a. The JVA or the Protocol must specify the company/partner and the name of the office
designated as the authorized representative of the joint venture.
b. Each partner of the joint venture shall submit their respective Legal (I.A) ⎯Eligibility Documents.
c. The submission of technical and financial eligibility documents by any of the joint venture partners
constitutes compliance: Provided that, the partner responsible to submit the NFCC shall likewise submit
the Statement of all of its ongoing contracts and latest Audited Financial Statements.
****IF NOT APPLICABLE INDICATE IN A SEPARATE SHEET WITH TABBING THAT JOINT VENTURE
AGREEMENT IS NOT APPLICABLE****
124
OTHER DOCUMENTARY REQUIREMENTS UNDER RA NO. 9184 (as applicable)
1. For foreign bidders claiming by reason of their country’s extension of reciprocal rights to Filipinos] Certification
from the relevant government office of their country stating that Filipinos are allowed to participate in
government procurement activities for the same item or product.
2. Certification from the DTI if the bidder claims preference as a Domestic Bidder or domestic Entity

1. Original of duly signed and completed FINANCIAL BID FORM. And
2. Original of duly signed and completed PRICE SCHEDULE FORM.
Note well:
1. Any missing, incomplete, or patently insufficient document in the above-mentioned checklist shall be
considered “FAILED” (as per Rule IX, Sec. 30.1 of R.A. No. 9184).
125
64. PROCESSING OF BIR FORM 2307
Description of Service: The Accounting Section is responsible for the issuance of BIR form 2307. Operating Hours: Monday to
Friday, except for holidays; 8:00 am – 5:00 pm.
OFFICE Accounting Section
TYPE OF G2B – Government to Business
WHO MAY AVAIL All NCMH employees and Goods Suppliers
FOR SUPPLIER OF GOODS PAID BY DIRECT PAYMENT
(DISBURSEMENT VOUCHER)
Disbursement Voucher (1) original / photocopy Accounting Section
FOR PURCHASE BY PETTY CASH FUND OR CASH
ADVANCE
BIR Form 2303 (1) original / photocopy Requesting Party
Sales Invoice or Official Receipt (1) original / photocopy Requesting Party
Purchase Request (1) original copy Requesting Party
Accomplished BIR Form 2307 (1) original copy Requesting Party
1. Proceed to Accounting 1. Receive and verify None 25 minutes Admin Officer IV
Section and submit the documents Accountant III / IV
applicable requirements: (Accounting Section)
For supplier of goods:
For supplier of goods: Check if the withheld tax has
Disbursement Voucher already been remitted to the
(DV) BIR
If the amount has been
For purchase by Petty remitted: Process the BIR
Cash Fund or Cash form 2307
Advance: BIR form 2307 If amount is yet to be
and Purchase Request remitted: Inform the
supplier to come back and
For purchase by Petty submit a request again on a
Cash Fund or Cash specific time when said
Advance (BIR Form amount has been remitted
2307 for signature)
Accomplished BIR form For purchase by Petty
2307 and Purchase Cash Fund or Cash
Request Advance Process the BIR
form 2307 and explain to the
requesting party how to fill
up the BIR Form 2307 for
future transactions
For purchase by Petty

Cash Fund or Cash
Advance (BIR Form 2307
for signature) Check the
details of the BIR Form 2307
126
If correct: Sign the BIR
Form 2307
If incorrect: Return the form
and inform the requesting
party of the error noted.
2. Receive the BIR form 2. Issue the signed BIR form None 5 minutes Admin Officer IV
2307 and sign in the 2307 (Accounting Section)
record log for released
BIR Form 2307
127
65. REQUEST FOR A COPY OF PAID DISBURSEMENT VOUCHER (DV)
FOR REQUEST OF RETENTION
Description of Service: To safeguard the information of the suppliers, identification of the requesting party must be established
prior to the release of the requested document. Operating Hours: Monday to Friday, except for holidays, 8:00 am – 5:00 pm.
TYPE OF
CLASSIFICATION Simple G2B – Government to Business
TRANSACTION
WHO MAY AVAIL All NCMH suppliers
Sales Invoice or Official Receipt Requesting Party
Purchase Order Number Requesting Party
Summary of Details (for request of multiple DVs) Requesting Party
1. Provide all the 1.1 Receive the documents None 5 minutes Admin Aide III / VI
requirements above if provided by the requesting Admin Assistant III
possible party Accountant III
1.2 Search through the None 10 minutes (Accounting Section)
eNGAS using the details
provided
1.3 Pull out the copy from the None 1 day
Accounting Section
retained files to Photocopy
each
None 5 minutes
2. Receive the copy of the 2. Release the copy to the None 5 minutes Admin Aide III / VI
requested Disbursement requesting party Admin Assistant III
Voucher/s (Accounting Section)
END OF TRANSACTION None 1 day and 25 minutes
128
66. REQUEST FOR BILLING STATEMENT
Description of Service: This service involves the processing of Pre-Bill of foreign patients and Certified True Copy of Statement
of Account of patients from Pay Pavilion. Operating Hours: Monday to Sunday, 8:00 am – 5:00 pm (No Noon Break)
OFFICE Billing and Claims Section – Billing Unit
TYPE OF
TRANSACTION
WHO MAY AVAIL All foreign in- patients and in-patients from Pay Ward Pavilion
Valid ID (2) original copies Relative/Guardian of the Patient
1. Proceed to Billing Unit to 1. Check and verify the None 5 minutes Administrative Officer
request Statement of identifications provided (Billing Unit)
Account and present 2
valid ID
2. Receive Pre-Bill Statement 2. For foreign client: None 5 minutes Administrative Officer
of Account / Certified True Issue Pre-Bill statement of (Billing Unit)
Copy of Statement of account
Account
For payward:
Issue Certified True Copy of
Statement of Account
129
67. REQUEST FOR PHILHEALTH ELECTRONIC MEMBER REGISTRATION AND
RECORDS AMENDMENT (EMRRA)
Description of Service: Updating and/or amendment of existing Philhealth member’s record for Philhealth benefit availment.
Operating Hours: Monday to Friday, except for holidays; 8:00 am - 5:00 pm (No Noon Break).
OFFICE Billing and Claims Section – Claims Unit
WHO MAY AVAIL All Philhealth members
Valid ID (1) original and (1) photocopy Any government agencies
Birth Certificate (1) photocopy Philippine Statistics Authority
Marriage Certificate (for legal spouse who is not yet a member)
Philippine Statistics Authority
(1) photocopy
Senior Citizen’s ID (for senior citizen psychiatric patient without
Office of Senior Citizens Affairs (OSCA)
Philhealth Membership)
1. Proceed to Claims Unit for 1.1 Ask stakeholder for key point None 10 minutes Admin Aide I - VI
updating and/or information and instruct to (Claims Unit)
amendment of Philhealth provide documentary
record requirements as needed
1.2 Provide Philhealth Member
Registration Form (PMRF)
2. Submit accomplished 2.1 Review PMRF and ensure None 15 minutes Admin Aide I - VI
Philhealth Member completeness of additional (Claims Unit)
Registration Form (PMRF) documents submitted
and present documentary
requirements (Notify the client that the
PHIC may require additional
documents as needed)
2.2 Process the documents

through EMRRA
130
68. REQUEST FOR PHILHEALTH MEMBER ELIGIBILITY
Description of Service: Processing, validation and issuance of Philhealth Benefit Eligibility Form. Operating Hours: Monday to
Sunday; 8:00 am to 5:00 pm (No Noon Break).
OFFICE Billing and Claims Section – Claims Unit
WHO MAY AVAIL All Philhealth members and its qualified dependents (spouse and children below 21 years old)
Valid ID indicating Date of Birth (1) original Any government agency or place of employment
If the member is classified as Indirect Contributor:
Latest Member Data Record (1) photocopy Philippine Health Insurance Corporation
For Direct Contributors – Individually Paying Member: Philippine Health Insurance Corporation, Any payment
Official Receipts of Premium Contribution (1) photocopy partners
If the member is Direct Contributor (Employed):
Claim Signature Form (CSF) and/or Certificate of Premium Employer
Contribution (signed by employer)
If Patient is a Minor (below 21 years old) and not a
Philhealth member/undeclared dependent: Philippine Statistics Authority
Birth Certificate (1) photocopy
1. Secure Philhealth Benefit 1. Provide Philhealth Benefit None 4 minutes Admin Aide I – VI
Eligibility Requisition Form Eligibility Requisition Form (Claims Unit)
from the Claims Unit Office
2. Submit Accomplished 2.1 Review and evaluate PBEF None 18 minutes Admin Aide I – VI
PhilHealth Benefit Eligibility Requisition Form (Claims Unit)
Requisition Form and 2.2 Process the PBEF
present all documentary Requisition Form through
requirements eClaims
2.3 Print out generated
Philhealth Benefit Eligibility
Form (PBEF) from eClaims
2.4 Verify member Eligibility
status through PCares-On-
Duty
3. Affix signature on the 3.1 Inform client’s Philhealth None 3 minutes Admin Aide I – VI
generated Philhealth eligibility status and to (Claims Unit)
Benefit Eligibility Form submit documentary
(PBEF) requirements as needed
prior to discharge
3.2 Instruct to return to ward
where the patient is confined
and submit the generated
PBEF to the Nurse-on-duty
to be affixed to the patient’s
chart
131
PART II
INTERNAL SERVICES
132
1. APPLICATION FOR ADVANCED PROFESSIONAL COURSES
Description of Service: This service details the process in applying for local and foreign scholarships, post-graduate courses,
fellowship, sub-specialty, and similar highly-technical courses.
TYPE OF
TRANSACTION
WHO MAY AVAIL All NCMH employees
Letter of Intent (1) original copy Requesting Individual
Certification Form PETRO
Memorandum of Agreement PETRO
DOH requirements for Lateral Entry (Fellowship and Residency
PETRO
Training) based on DOH Memorandum
1. Submit letter of intent 1.1 Receive and record LOI None 5 minutes Training Assistant
noted by supervisor 1.2 Provide checklist of (PETRO)
addressed to MCC II thru requirements
PETRO
2. Seek clearance from 2. Evaluate eligibility of None 2 days Supervising

concerned offices to individual (affix signature) Administrative Officer
determine eligibility (HRMO)
a. HRMO
b. Legal Section Attorney III
c. PETRO (Legal Section)
Medical Specialist IV
(PETRO)
3. Submit signed Clearance 3.1 Receive and check all None 5 minutes Admin Officer II
Form and other documentary requirements (PETRO)
documentary 3.2 Schedule interview of
requirements to PETRO applicant with the Chief
PETRO
For Lateral Entry: Schedule

interview of applicant with
Chief PETRO and CMPS-
Hospital Service
4. Undergo interview 4.1 Conduct Interview None 1 hour Medical Specialist IV
(PETRO)
CMPS-Hospital
(CMPS Office)
4.2 Approve / Disapprove 3 days MCC II

recommendation (MCC Office)
133
5. Receive copy of letter 5. Issue copy of the letter with None 5 minutes Training Assistant
with notation notation and provide (PETRO
documents to accomplish
6. Upon completion, submit 6.1 Receive accomplished None 2 days Training Assistant
required documents to documents (PETRO)
PETRO 6.2 Affix signature to Medical Specialist IV
Memorandum of Agreement/ (PETRO)
Return Service Agreement/ Supervising
Training Agreement Administrative Officer
(HRMO)
CMPS II/ CAO/ FMO
(Concerned Chief of
Service)
MCC II
(MCC Office)
134
2. APPLICATION FOR STUDY LEAVE
Description of Service: This service details the process in request for study leave to fulfill obligations in relation to postgraduate
requirements, attend review classes, and take board/bar examinations.
TYPE OF
TRANSACTION
Letter of Intent (1) original copy Requesting Individual
Certification Form PETRO
NCMH Return Service Agreement PETRO
1. Submit letter of intent noted 1.1 Receive letter of intent None 5 minutes Training Assistant
by supervisor, addressed to 1.2 Issue certification form (PETRO)
MCC II thru PETRO
2. Seek clearance from 2. Evaluate eligibility of None 2 days Supervising

concerned offices to individual (affix signature) Administrative Officer
determine eligibility (HRMO)
a. HRMO
b. Legal Section Attorney III
c. PETRO (Legal Section)
Medical Specialist IV
(PETRO)
3. Submit Clearance Form 3.1 Check and receive None 5 minutes Training Assistant
and wait for schedule of certification (PETRO)
interview 3.2 Schedule interview with
Chief PETRO
4. Return to PETRO for 4.1 Conduct interview None 1 hour Medical Specialist IV
interview 4.2 Endorse recommendation to (Chief PETRO)
MCC for notation
4.3 Approved/ disapprove 2 days Medical Center Chief
request II
(MCC Office)
5. Submit notarized Return 5. Receive and check None 5 minutes Training Assistant
Service Agreement (RSA) notarized RSA (PETRO)
to PETRO
6. Proceed to HRMO to file 6. Process leave application None 2 days Admin Aide IV
leave application Admin Assistant II
(Refer to HRMO Citizen’s (Leave Unit, HRMO)
Charter-Application for
Leave)
135
3. INFRASTRUCTURE WORK REQUEST
Description of Service: The Planning and Development Section facilitates and accomplishes infrastructure work requests
pertaining construction (new) and/or rehabilitation/repair(existing) of facilities. Operating Hours: Monday to Friday, except for
holidays; 8:00 am to 5:00 pm (No Noon Break).
OFFICE Planning and Development Section
TYPE OF
TRANSACTION
Infrastructure Work Request Form (1) original copy Administrative Unit Office
Available materials/supplies
Request Slip (1) original copy Administrative Unit Office
Request and Issue Slip (1) original copy
Unavailable materials/supplies
Purchase Request (2) original copies Administrative Unit Office

1. Properly accomplish 1.1 Receive and evaluate the None 30 minutes Administrative Aide III
Infrastructure Work completeness and records (PDS)
Request form and submit to the Infrastructure Work
the Planning and Request form
Development Section 1.2 Forward the form to the
(PDS) concerned Unit Head
2. Assist the Planning and 2.1 Conduct on-site None 1 hour and 15 Supervising
Development Section evaluation/inspection minutes Administrative Officer
personnel during on-site relative to the requested (PDS)
evaluation/inspection “Description of Work”.
2.2 Accomplish and submit to
the end-user the Estimate
Form reflecting the needed
materials/supplies for the
requested maintenance
work.
3. Accomplish and submit to 3.1 Receive, evaluate, record, None 15 minutes Administrative Aide III
the Planning and and forward the Request Slip (PDS)
Development Section the and Request and Issue Slip
following: to the Warehouseman
If materials are available: 3.2 Issue requested materials 15 minutes Warehouseman
▪ Request slip (PDS)
▪ Request and Issue
Slip based on the
materials/supplies
listed on the Estimate
Form. The Estimate
Form shall be
attached together with
the slips.
If materials are
unavailable:
▪ Purchase Request 3.1 Receive, evaluate, record, 15 minutes Administrative Aide III
based on the and forward the Purchase (PDS)
136
materials/supplies Request to the MCC for
listed on the Estimate approval
Form. The Estimate 3.2 Approve Purchase Request 3 days MCC II
Form shall be (MCC Office)
attached together with
the request 3.3 Receive the approved PR 7 days Administrative Aide III
and purchase the materials based on COA (PDS)
Circular 2013-
001 and RA
9184
4. Assist the Planning and 4. Proceed to the project site None 5 days Supervising
Development Section for the commencement of Administrative Officer
personnel during conduct of the infrastructure work (PDS)
infrastructure work
5. Certify the accomplishment 5.1 Receive the signed None 5 minutes Supervising
of the requested Infrastructure Work Request Administrative Officer
infrastructure work by form and submit to the (PDS)
signing the submitted Planning and Development
Infrastructures Work Section
Request Form 5.2 Receive the document. 10 minutes Administrative Aide III
Record and file accordingly (PDS)
5 days, 2 hours, and 30 minutes – if
materials are available
materials are unavailable
137
4. ISSUANCE OF CERTIFICATE FOR LEARNING AND DEVELOPMENT ACTIVITIES
Description of Service: The PETRO issues certificate for resource speaker, facilitator, and participant of learning and development
activities conducted by NCMH offices.
TYPE OF
TRANSACTION
WHO MAY AVAIL All organizing NCMH offices
Request for Certification Form (Rev 2) PETRO
List of Participants (soft copy MS Word Format) PETRO
Post-Training Completion Report PETRO
1. Submit accomplished 1.1 Receive and check details of None 5 minutes Training Assistant
certification form with the request with complete (PETRO)
following attachments: attachments
a. Post-Training 1.2 Check email for the list of
Completion Report participants in soft copy
b. List of participants in
soft copy (email to:
petro@ncmh.gov.ph)
2. Wait for release of 2.1 Prepare certificates based None 2 days Admin Officer II
certificates on the given soft copy and (PETRO)
post training completion
report
2.2 Release certificates to
participants or requesting
office
138
5. ISSUANCE OF CERTIFICATES FOR STUDENT AFFILIATES
Description of Service: The Professional Education, Training and Research Office (PETRO) releases the completion certificates
of student affiliates.
TYPE OF
TRANSACTION
WHO MAY AVAIL NCMH offices with student affiliates
Request of Certificate of Completion (Student internship/
PETRO
affiliation)
Annex A – List of student affiliates (electronic copy) PETRO
1. Submit to PETRO the 1. Receive and check request None 10 minutes Admin Aide VI
Request of Certificate of for completeness (PETRO)
Completion and send the
Annex A via email:
petro@ncmh.gov.ph
2. Wait for the issuance of 2. Prepare and issue the None 2 days Admin Aide VI
certificates certificates (PETRO)
139
6. PROCESSING OF DOCUMENT REQUEST FORM
Description of Service: The center's mandate is to ensure that all document preparation, addition, amendment, and deletion are
properly processed, prepared using a uniform format, consistent with the style and content, duly reviewed and approved for
adequacy, and updated and distributed controlled copies to appropriate locations and made available at points of use. Operating
Hours: Monday to Friday, except for holidays; 8:00 am to 5:00 pm (No Noon Break).
OFFICE Quality Management Office (QMO)
TYPE OF
TRANSACTION
Document Request Form (1) original copy Quality Management Office/ NCMH website
Draft of the requested document Requesting Client

1. Submit a completed 1.1. Receive and review duly None 1 hour Nurse I
Document Request Form accomplished Document (Quality Management
(DRF) along with a draft of Request Form (DRF) and Office)
the requested document. attachments
If incomplete: return to the

process owner with detailed
instructions
1.2. Encode and enroll

new/amended documents Nurse I
in the Quality Management (Quality Management
System (QMS) or delete Office)
documents from the master
list
1.3. Evaluate and review 1 day Nurse IV

encoded draft, and For ordinary (Quality Management
approve/disapprove the document Office)
DRF 3 days
For
If disapproved: return to Section/Pavilion
process owner and state Manuals
reason/s for disapproval
2. Receive the document for 2. Forward the encoded None 10 minutes Nurse I
review and approval of the document to the process (Quality Management
Service Chief owner for approval Office)
3. Submit document to 3.1 Receive document None 2 days Admin Assistant

respective Service Chief for 3.2 Approve document (Office of the Service
signature Chief)
4. Return the signed 4. Receive approved None 1 day Nurse I / IV
document to the QMO document and forward it to (Quality Management
QMR for acknowledgement Office)
of approval
140
5. Receive the controlled copy 5.1 Update master lists and None 15 minutes Admin Assistant I
of the requested document release the controlled Nurse I
copies (Quality Management
5.2 Retrieve any obsolete or Office)
deleted documents from the
process owners and stamp
the pages with “Obsolete-
Retained”
4 days, 1 hour, and 25 minutes
Ordinary Document Request
6 days, 1 hour, and 25 minutes
Section/Pavilion Manual
141
7. PROVISION OF DATA ALLOWANCE FOR LEARNING AND
DEVELOPMENT ACTIVITIES
Description of Service: The PETRO provides data allowance to NCMH employees who will undergo learning and development
(LD) activities with no or limited internet access. Allowable rate shall be in accordance to the circular release by the Department of
Budget and Management.
TYPE OF
TRANSACTION
Proof of attendance to LD activity (e.g. copy of Hospital Order,
Requesting employee/ individual
approved Training Request Form)
1. Online register at least one 1. Check registration thru None 5 minutes Training Assistant
day prior to the attendance Google Sheet (PETRO)
through
bit.ly/PETRODataAllowance
or proceed to PETRO for
manual registration.
2. Submit proof of attendance to 2.1 Verify proof of attendance None 5 minutes Training Assistant
PETRO through hard copy or vis-à-vis registration (PETRO)
by email (email to: 2.2 Send confirmation message
petro@ncmh.gov.ph). to the registered mobile
number
3. Receive data allowance and 3. Send data allowance None 10 minutes Admin Assistant I
proceed to PETRO to sign (PETRO)
proof of acknowledgement of
receipt.
142
8. REQUEST FOR CERTIFICATE OF NO PENDING CASE /
CERTIFICATE OF GOOD MORAL
Description of Service: The Legal Section issues Certificate of No Pending Case (CNPC) and Certificate of Good Moral to
employees of the National Center for Mental to be used for whatever lawful purpose it may serve. Operating Hours: Monday to
Friday, except for holidays; 8:00 am to 5:00 pm (No Noon Break).
OFFICE Legal Section
TYPE OF
TRANSACTION
WHO MAY AVAIL Current and separated NCMH employees
Certificate of No Pending Case (CNPC) Request slip Legal Section
Certificate of Good Moral Request Slip Legal section
1. Fill-out and submit the 1.1 Verify the correctness of the None 2 minutes Legal Assistant
request form provided by information written
the Legal Section 1.2 Confirm if the client has a Legal Assistant II
pending administrative case
in NCMH based on record.
1.3 Draft the Certificate Admin Assistant
(Legal Section)
2. Return after three working 2.1 Sign the CNPC/Good Moral None 2 minutes Attorney III
days to claim CNPC / 2.2 Issue the CNPC / Good Legal Assistant I
Good Moral Moral to the client Legal Assistant II
CNPC / Good Admin Assistant
Moral will be (Legal Section)
released after 3
working days
143
9. RESEARCH GRANTS
Description of Service: The PETRO intends to support the development of mental health-related research projects and studies,
by providing research grants, to the NCMH employees which geared towards the attainment of NCMH mandate.
TYPE OF
TRANSACTION
Request for Research Grant (Form A) PETRO
Proposed Line-Item Budget and Distribution Plan (Forms B.1
PETRO
and B.2)
Contract of Agreement PETRO
Research Ethics Clearance Research Ethics Committee
1. Submit documentary 1. Receive and check accuracy None 2 minutes Admin Officer II
requirements to PETRO and completeness of (PETRO)
submitted documents
2. Wait for feedback on 2.1 Forward request to Chief None 2 days Admin Officer II
request PETRO (PETRO)
2.2 Recommend for approval to Medical Specialist IV

Medical Center Chief (PETRO)
2.3 Approval of the request Medical Center Chief

II
(MCC Office)
3. Return to PETRO to get 3. Provide copy of the letter None 5 minutes Admin Officer II
the copy of the letter with with notation (PETRO)
notation
If approved: Issue Contract
of Agreement for signature
and notary
4. Submit to PETRO the 4. Receive original copy of the None 2 minutes Admin Officer II
notarized Contract of Contract of Agreement (PETRO)
Agreement
Instruct to proceed with the
conduct of research study
144
10. TRAINING - ENROLLMENT / IN-HOUSE / CONSULTING SERVICES
Description of Service: This service details the process in requesting for an enrollment to, conduct of, and / or consulting services
of a learning provider.
TYPE OF
TRANSACTION
Training Request Form (TRF) PETRO
Training Agreement PETRO
Course Description/Outline Learning Service Provider
Learning Design Requesting Office
Terms of Reference (TOR) for Consulting Services Requesting Office
1. Submit necessary 1. Receive and review None 10 minutes Training Assistant
documents completeness of documents. (PETRO)
For Enrollment If complete: Endorse to
▪ Training Request Form Chief PETRO for approval
(TRF)
▪ Course Description If incomplete: Return to the
▪ Training Agreement (if Requesting Party for
applicable) appropriate action
For In-House L&D
▪ TRF
▪ Learning Design
▪ Resource Person’s
Curriculum Vitae
For Consulting Services
▪ TOR
2. Wait for the notification. 2.1 Approve request and None 1 day Medical Specialist IV
May proceed with the endorse to MCC II (PETRO)
activity once with Hospital
Order 2.2 Approve/Disapprove request 2 days Medical Center Chief
II
(MCC Office)
2.3 Prepare and issue Hospital 3 days
Order Admin Assistant I
(HRMO)
145
11. APPLICATION FOR COVID-19 SICKNESS AND DEATH COMPENSATION
FOR ELIGIBLE NCMH EMPLOYEES
Description of Service: Republic Act (RA) No. 11494 entitled, “Bayanihan to Recover as One Act” mandated the grant of COVID-
19 sickness and death compensation to public and private health workers who have contracted COVID-19 in the line of duty to
recognize their invaluable contributions to the country’s COVID-19 response. Operating Hours: Monday to Friday, 7:00 am to 4:00
pm (No Noon Break).
OFFICE Malasakit Center
TYPE OF
TRANSACTION
WHO MAY AVAIL All NCMH employees regardless of appointment status including outsourced personnel
Certificate of Employment or Contract (indicate period of
employment, position, and place of assignment) (1) original Human Resource Management Office (HRMO)
copy
Any Government- issued valid IDs (1) photocopy Government agencies/ Issuing agencies
Comprehensive Medical / Clinical Abstract or Discharge Human Resource Management Office (HRMO)
Summary (if hospitalized) and/or Medical Certificate/Symptom Respective hospital where the Non- HCW/HCW was confined
Monitoring Sheet (if facility/home isolation) (1) Original or CTC or examined
Molecular and Diagnostic Pathology test with Positive result
such as (RT-PCR) or (AgT) FDA-certified facility-based Rapid Respective DOH-Acredited Molecular Laboratory where the
Non- HCW/HCW specimen was tested
antigen test with positive Result (1) Original or CTC
For February 01, 2020 - June 30, 2021 infections: Certificate
of Exposure to Suspect, Probable, or Confirmed COVID-19
Cases with List of Duties and Responsibilities Duly signed and issued by Immediate Supervisor of Non-
For July 01, 2021 until the end of Public Health Emergency: HCW/HCW claimant
Certificate of Involvement to COVID-19 Response
Special Power of Attorney (SPA) signed by health worker in
case another person will process for the COVID compensation Appointing Non-HCW/HCW whom giving authority
(1) Original copy
Additional requirements for Severe/Critical Cases:
Official chest X-ray result (1) CTC Respective hospital where the HCW was examined
Additional requirements for Death Cases: The heirs of the
deceased HCW shall likewise submit the following minimum
requirements to claim the death compensation: 1. Philippine Statistical Authority / other issuing agencies
1. One (1) original copy of PSA Death Certificate 2. Philippine Statistical Authority / other issuing agencies
2. One (1) original copy of PSA Certificate of No Marriage 3. Government agencies/ Issuing agencies
(CENOMAR) 4. Philippine Statistical Authority / other issuing agencies
3. One (1) photocopy of any valid IDs of the claimant 5. Philippine Statistical Authority / other issuing agencies
4. One (1) original copy of PSA Marriage Certificate (if 6. Appointing Non-HCW/HCW whom giving authority
claimant is the surviving spouse) 7. Philippine Statistical Authority / other issuing agencies /
5. One (1) original PSA Birth Certificate of child/children Respective Court of Law
(if claimant is/are the surviving child/children) 8. Philippine Statistical Authority / other issuing agencies
6. One (1) original or CTC of SPA for the authorized 9. Government agencies/ Issuing agencies
sibling to process and receive the compensation
7. One (1) original copy of Certificate of Finality of
Annulment/ Nullity or PSA Annotated Marriage
Certificate of the parents (if applicable)
8. One (1) original copy of PSA Birth Certificate/s of
minor or incapacitated child/children and One (1)
original or CTC of Affidavit of Guardianship of minor
146
and incapacitated child/children (if claimant is/are
minor or incapacitated child/children of the deceased)
9. One (1) photocopy of valid ID of any representative of
claimant of the deceased
Any representative of the deceased health worker should
Government agencies/ Issuing agencies
provide one (1) photocopy of his / her valid ID.
The DOH reserves the right to obtain additional information / documents in whatever manner, as applicable to determine the
eligibility of claimants.
1. Submit the complete 1. Receive and review the None 20 minutes Chief, Medical Social
requirements to Malasakit submitted requirements Service Section and
Center Malasakit Center
Operations Manager
(Malasakit Center)
2. Wait for the notification via 2.1 Case manager assess the None 1 day Chief, Medical Social
email if the application is completeness and Service Section and
found eligible for authenticity of the Malasakit Center
processing requirements then encodes Operations Manager
the details through (Malasakit Center)
COMPASS
2.2 Case manager shall forward None 1 day Chief, Medical Social
the application to Senior Service Section and
case manager for approval/ Malasakit Center
disapproval Operations Manager
(Malasakit Center)
2.3 If approved, case manager None 2 days Chief, Medical Social
will be sending the Service Section and
documents to the Medical Malasakit Center
Center Chief for signing of Operations Manager
the Certificate of (Malasakit Center)
Involvement
If disapproved, the case

manager will be sending a
disapproval notice to the
applicant via email
Note: Claimant may file a

Motion for Reconsideration
(MR) with the Office of the
Secretary of Health within
ten (10) days from the
receipt of notice of
disapproval. Otherwise, MR
received more than 10 days
from notification will be
denied.
147
2.4 For approved claims: None 2 days Chief, Medical Social
Senior case manager shall Service Section and
forward the application to Malasakit Center
finance service via Operations Manager
COMPASS and the case (Malasakit Center)
manager shall process
generation of fund request
and which shall be signed
by the Head of Agency.
Once signed, case manager
shall send the scanned copy
to the DOH- CO
Management Services
Team (MST)
2.5 Case manager shall tag the None 3 hours Chief, Medical Social
application of claims via Service Section and
COMPASS as “Approved Malasakit Center
but still waiting for Fund” Operations Manager
and send notification to the (Malasakit Center)
applicant
3. Receive the compensation 3. Once fund was received, None 4 hours and 40 Chief, Medical Social
through ATM case manager shall minutes Service Section and
endorsed the physical Malasakit Center
documents to finance Operations Manager
service for processing and (Malasakit Center)
releasing of payment
through ATM
148
12. RISOGRAPH
Description of Service: This service involves processing of Risograph Requests. Operating Hours: Monday to Friday, except
for holidays; 8:00 am to 5:00 pm (No Noon Break).
TYPE OF
TRANSACTION
Photocopy/Risograph request slip (1) original copy Health Information Management Section
Document for Production (1) original or photocopy Requesting personnel
A4 size paper reams corresponding to number of reams
Pavilion/Office of origin
requested
1. Proceed to the HIMS Main 1.1. Receive request slip None 2 days and 55 Admin Aide I
Office and submit filled out 1.2. List down request for minutes (HIMS)
Photocopy/Risograph queuing
request slip indicating the 1.3. Reproduce document
form number to be
reproduced along with A4
size paper reams
corresponding to number of
reams requested
2. Proceed to the HIMS Main 2. Issue requested documents None 5 minutes Admin Aide I
building to pick up (HIMS)
reproduced documents and
sign the receiving form
149
13. APPOINTMENT PROCESS
Description of Service: The Human Resource Management Office is responsible for the processing of the appointment papers of
the appointed NCMH applicants. Operating Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm.
OFFICE Human Resource Management Office (HRMO)
TYPE OF
TRANSACTION
WHO MAY AVAIL All appointees
Duly Accomplished Personal Data Sheet (PDS) (3) original Downloadable Form
https://ncmh.gov.ph/index.php/issuances-downloadable-
copies
forms#hrmo-forms
Work Experience Sheet (3) original copies Downloadable Form
https://ro4.csc.gov.ph/downloads/file/31-pds_wes
Statement of Assets and Liabilities (SALN) (3) original copies HRMO Window 1 & 2
Medical Laboratory Results (2) original copies NCMH Laboratory & X-ray
Dental Laboratory Results (2) original copies NCMH Pavilion 1 Dental Section
Oath of Office (3) original copies HRMO Window 1 & 2
Certificate of Eligibility (if applicable) Civil Service Commission
NBI Clearance (1) original copy NBI
Pag-Ibig Form (1) original copy HRMO Window 1 & 2
Landbank Form (1) original copy HRMO Window 1 & 2
Philhealth Form (1) original copy HRMO Window 1 & 2
Diploma (1) Certified True Copy (CTC) Respective University
Transcript of Records (1) Certified True Copy (CTC) Respective University
Certificate of Employment (1) original copy/CTC each Respective Employers
Marriage Certificate (if applicable) Philippine Statistics Office
Training Certificates (1) photocopy each Respective training organizer
Birth Certificate – (1) original copy (1) photocopy Philippine Statistics Office
Tin Verification BIR/ Online: TIN verifier mobile app.
Passport size picture (5pcs) Personal
1. Proceed to HRMO and 1. Issue charge slip and None 5 minutes Admin Assistant I / II /
secure charge slip for instruct appointees on the III
medical and dental procedures (Appointment Unit,
evaluation HRMO)
2. Proceed to Collection and 2. Receive the payment and Php1,500 10 minutes Administrative Officer
Deposit Unit and provide issue official receipt III (Collection and
amount to be paid Deposit Unit)
150
3. Proceed to Pavilion 7 and 3.1 Assess client None 1 day Medical Specialist II /
Dental Clinic for the 3.2 Issue fit to work clearance III
medical and dental (Pavilion 7)
evaluation Dentist
(Dental Section)
4. Proceed to HRMO and 4.1 Review the submitted None 7 days Admin Assistant I / II /
submit the required documents III
documents (Appointment Unit,
HRMO)
4.2 Prepare appointment papers
and endorse the 1 day Administrative
appointment documents for Assistant II/
required signatures (Appointment Unit,
HRMO)
5. Review and sign 5.1 Assist in the signing of None 2 minutes Admin Assistant II
appointment papers appointment papers (Appointment Unit,
5.2 Provide schedule for the HRMO)
Oath of Office
6. Recite the Oath of Office 6. Conduct Oath of Office None 5 minutes Medical Center Chief
II (MCC Office)
Php
END OF TRANSACTION 9 days and 22 minutes
1500.00
151
14. COMPENSATORY TIME-OFF
Description of Service: The Human Resource Management Office is responsible for the processing of Certification of Overtime
Rendered filed by the employees of NCMH. Operating Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm.
TYPE OF
TRANSACTION
WHO MAY AVAIL NCMH Regular Employees who rendered overtime
Compensatory Time-Off Form (3) original copies HRMO Window 5 & 6

DTR (1) photocopy Requesting Employee
Hospital Order (if applicable) (1) photocopy Employee Relation Unit, HRMO
1. Proceed to HRMO, Leave 1.1 Receive and check for the None 5 minutes Admin Aide IV
Unit and submit duly completeness of data Admin Assistant II
accomplished Certification (Leave Unit, HRMO)
of Overtime Rendered
Form and DTR 1.2 Record the CTO application 1 day Designated Offices
form and forward to (per service)
designated signatories for
approval
1.3 Forward the approved and 1 day Admin Aide IV

duly processed COC Admin Assistant II
application to the 201 File (Leave Unit, HRMO)
Section for record keeping
2. Avail compensatory time-off N/A None N/A N/A
152
15. ISSUANCE OF AUTHORITY TO TRAVEL
Description of Service: This process covers the processing of the Travel Authority Certification. Operating Hours: Monday to
Friday, except for holidays; 8:00 am – 5:00 pm.
TYPE OF
TRANSACTION
WHO MAY AVAIL NCMH employees travelling abroad
Travel Authority Form (3) original copies HRMO Employee Relations Unit
Approved Leave Application (1) original copy HRMO Leave Unit
Proof of Travel Destination (1) original copy Requesting employee
1. Proceed to HRMO, 1. Provide and assist None 3 minutes Admin Assistant II
Employee Relations Unit Employee in filling out of (Employee Relations
and request for Travel forms and Transactions Unit,
Authority Form HRMO)
2. Proceed to the Authorized 2. Sign the Travel Authority None 2 days Immediate Supervisor
Signatories: Form
a. Immediate Chief of
Supervisor Service/Section
b. Chief of Service/
Section Medical Center Chief
c. MCC II II (MCC Office)
with the approved leave
and other documents as
attachment
3. Submit the duly signed 3. Receive and check the None 2 minutes Admin Assistant II
Travel Authority form to completed forms and (Employee Relations
HRMO for dry sealing attachments then provide and Transactions Unit,
official dry seal HRMO)
4. Receive sealed Travel 4. Issue sealed Travel None 2 minutes Admin Assistant II
Authority Certificate Authority Certificate and (Employee Relations
secure (1) copy for record and Transactions Unit,
keeping HRMO)
153
16. ISSUANCE OF GATE PASS
Description of Service: The Material Management Section ensures that the equipment and semi-expendable equipment to be
brought out of the premises of the Center is a personal property of the requisitioning officer. Operating Hours: Monday to Friday,
except for holidays; 8:00 am to 5:00 pm (No noon Break).
OFFICE Material Management Section (MMS)
TYPE OF G2G – Government to Government
TRANSACTION G2B – Government to Business
WHO MAY AVAIL All NCMH employees, suppliers and contractors
Gate Pass Form (4) original copies Material Management Section
Valid I.D of the Requisitioning Officer (1) photocopy Government Agencies / Private Companies
Item/s to be brought out Office / Pavilion where the item/s is located
1. Request Gate Pass Form 1. Issue Gate Pass Form None 1 minute Admin Aide I
(For Personal Belongings) (MMS)
to the MMS Equipment Unit
Staff
2. Fill out the Gate Pass Form 2.1 Receive and check the I.D None 3 minutes Admin Aide I
properly and submit to the and gate pass for (MMS)
MMS Equipment Unit Staff completeness of information
2.2 Inspect and validate the 10 minutes
*With signature of the item/s listed on the gate
bearer, Head of Pavilion / pass form and forward the
Chief Engineer and form to the Chief of MMS for
Security Section approval
2.3 Approve gate pass 5 minutes Admin Officer V
(MMS)
3. Receive Gate pass 3. Issue gate pass None 1 minute Admin Aide I
(MMS)
154
17. ISSUANCE OF NCMH IDENTIFICATION CARD
Description of Service: This process covers the issuances of Identification Card for newly hired, promoted and requesting
employee for loss/faded NCMH ID. Operating Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm.
TYPE OF
TRANSACTION
WHO MAY AVAIL All active NCMH employees
Newly hired/ promoted
ID Request Form (1) original copy HRMO Window 2
2x2 I.D picture with white Background (1) copy Requesting employee
Loss ID
Affidavit of Loss (1) original copy Requesting employee
ID Request Form (1) original copy) HRMO Window 2
Official Receipt Collection and Deposit Unit (Pavilion 2)
ID Replacement
Request Letter (Addressed to Chief of HRMO) Requesting employee
ID Request Form (1) original copy HRMO Window 2
Official Receipt Collection and Deposit Unit (Pavilion 2)
PROCESSING PERSON
TIME RESPONSIBLE
1. Proceed to HRMO and 1. Issue I.D Request form None 5 minutes Admin Assistant I
accomplish I.D request and charge slip (HRMO)
form
2. Proceed to Collection 2. Process the payment and Php 50.00 – Loss/ 10 minutes Administrative Officer
and Deposit Unit and issue official receipt Replacement III (Collection and
provide amount to be Deposit Unit)
paid Free – Newly hired/
Promoted
employee
3. Return to the HRMO and 3.1 Receive and check for the None 2 days and 40 Admin Assistant I
submit official receipt completeness of data minutes (HRMO)
and I.D Request form 3.2 Process the request
with 2x2 I.D photo
4. Receive the 4. Issue Identification Card None 5 minutes Admin Assistant I

Identification card and (HRMO)
sign on the receiving log
book
Php 50.00 –
Loss/Replacement
END OF TRANSACTION 3 days
Free – Newly
Hired/Promoted
Employee
155
18. ISSUANCE OF SUPPLIES AND EQUIPMENT
Description of Service: The Material Management Section is responsible in the issuance of supplies, materials and equipment
indicated in the Request Slip. Operating Hours: Monday to Friday, except for holidays; 8:00 am - 5:00 pm (No noon Break).
OFFICE Material Management Section (MMS)
TYPE OF
TRANSACTION
Inventory of Supplies (1) original copy Requisitioning Office / Pavilion
Requisition Slip (1) original copy Requisitioning Office / Pavilion
Request and Issue Slip / Property Acknowledgement Report /
Material Management Section
Inventory Custodian Slip (1) original copy
1. Submit Requisition Slip and 1.1 Receive Requisition Slip and None 5 minutes Admin Aid I / IV
Inventory Report Inventory Report (MMS)
1.2 Check availability of stocks 15 minutes
1.3 Prepare
▪ Requisition and 15 minutes
Issuance Slip (RIS) for
Supplies
▪ Property
Acknowledgement
Receipt (PAR) for
equipment
▪ Inventory Custodian Slip
(ICS) for semi-
expendable properties
2. Sign RIS/ PAR/ ICS and 2. Receive RIS / PAR / ICS for 5 minutes Admin Officer
submit to MMS approval of the Chief of (MMS)
MMS
3. Receive Supplies 3. Issue available supplies / 30 minutes Admin Aide I/ VI

equipment (MMS)
156
19. LEAVE APPLICATION
Description of Service: The Human Resource Management Office is responsible for the processing of Leave of Absence filed by
the employees of NCMH. Operating Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm.
TYPE OF
TRANSACTION
WHO MAY AVAIL All NCMH regular employees
Duly Accomplished Leave Form CSC Form No. 6 (3) original HRMO Window 5 & 6 or at NCMH Official
Website:https://ncmh.gov.ph/index.php/issuances-
copies
downloadable-forms#hrmo-forms
Additional Requirements:
Sick Leave
1. Clearance Form (leave more than 30 days) (6) original 1. HRMO
copies 2. Attending Physician
2. Medical Certificate (leave more than 5 days) (1) original 3. MCC Office
copy
3. Approved Letter to MCC II (leave more than 30 days or for
scheduled operation) (2) original copies
Vacation Leave
1. Clearance Form (leave more than 30 days) (6) original 1. HRMO
copies 2. MCC Office
2. Approved Letter to MCC II (leave more than 30 days) (2)
original copies
Maternity Leave
1. Clearance Form– (6) original copies 1. HRMO
2. Approved Letter to MCC II (2) original copies 2. MCC Office
3. Medical Certificate (1) original copy 3. Attending Physician
4. Allocation of Maternity Leave to Husband/Relative (3) 4. Requesting Employee
original copies (If applicable) 5. Requesting Employee
5. Any proof of relation to employee (birth certificate,
marriage certificate, barangay certificate, etc.) (1)
photocopy (if applicable)
Paternity Leave
1. Birth Certificate of Child (1) photocopy 1. PSA
2. Marriage Certificate (1) photocopy 2. PSA
Quarantine Leave
1. Swab Result (1) original copy 1. Clinical Laboratory
2. Screening Form (1) original copy 2. Triage
3. Medical Certificate with date of confinement (1) original 3. Attending Physician
copy
Special Leave Benefits for Women
1. Clearance Form (2) original copies 1. HRMO
2. Approved Letter to MCC (2) original copies 2. MCC Office
3. Medical Certificate (1) original copy 3. Attending Physician
4. Operative/Laboratory Results (1) photocopy 4. Hospital
Study Leave
3. Contract (1) original copy 3. Requesting Employee
Terminal Leave
157
PROCESSING PERSON
TIME RESPONSIBLE
1. Submit the 1. Receive application for None 5 minutes Admin Aide IV
accomplished Leave leave and notates the Admin Assistant II
form CSC Form No. 6 Leave balances (Leave Unit, HRMO)
(revised 2020) to
HRMO
2. Submit the approved 2.1 Receive the application None 2 days Admin Aide IV
and signed leave form and check the applied Admin Assistant II
by the immediate details and the (Leave Unit, HRMO)
superior with complete completeness of
attachments attachments
If complete: Return one

copy to the employee
If incomplete: Return the

form to the employee.
This activity is repeated
until the document is
accepted
2.2 Process the leave

applications
158
20. MAINTENANCE WORK REQUEST
Description of Service: The Facilities and Equipment Maintenance Section facilitates and accomplishes maintenance work
requests from end-users. Operating Hours: Monday to Friday, except for holidays; 8:00 am - 5:00 pm (No Noon Break).
OFFICE Facilities and Equipment Maintenance Section
TYPE OF
TRANSACTION
Maintenance Work Request Form (1) original copy Administrative Unit Office
Available materials/supplies
Request Slip (1) original copy Administrative Unit Office
Request and Issue Slip (1) original copy
Unavailable materials/supplies
Purchase Request (2) original copies Administrative Unit Office

1. Properly accomplish 1.1 Receive and evaluate the None 30 minutes Administrative Aide I
Maintenance Work completeness and records (FEMS)
Request Form and submit the Maintenance Work
to the Facilities and Request Form
Equipment Maintenance 1.2 Forward the form to the
Section office concerned unit head
2. Assist the Facilities and 2.1 Conduct on-site None 1 hour and 15 Construction and
Equipment Maintenance evaluation/inspection minutes Maintenance General
Section personnel during relative to the requested Foreman
on-site evaluation/ “Description of Work” (FEMS)
inspection 2.2 Accomplish and submit to
the end-user the Estimate
Form reflecting the needed
materials/supplies for the
requested maintenance
work
3. Accomplish and submit to 3.1 Receive, evaluate, record, None 15 minutes Administrative Aide I
the FEMS office the and forward the Request (FEMS)
following: Slip and Request and Issue
If materials are Slip to the Warehouseman
available: 3.2 Issue requested materials 15 minutes Warehouseman
▪ Request slip (FEMS)
▪ Request and Issue
Slip based on the
materials/supplies
listed on the
Estimate Form. The
Estimate Form shall
be attached together
with the slips
If materials are
unavailable:
▪ Purchase Request 3.1 Receive, evaluate, record, 15 minutes Administrative Aide I
based on the and forward the Purchase (FEMS)
materials/supplies
159
listed on the Request to the MCC for
Estimate Form. The approval
Estimate Form shall
be attached together 3.2 Approve Purchase Request 2 days MCC II
with the request. (MCC Office)
3.3 Purchase the materials 7 days Construction and

based on COA Maintenance General
Circular 2013- Foreman
001 and RA (FEMS)
9184
4. Assist the Facilities and 4. Proceed to the project site None 5 days Construction and
Equipment Maintenance for the commencement of Maintenance General
Section personnel during the maintenance work Foreman
conduct of maintenance (FEMS)
work
5. Certify the 5.1 Receive the signed None 5 minutes Construction and
accomplishment of the Maintenance Work Request Maintenance General
requested maintenance Form and submits to the Foreman
work by signing the Facilities and Equipment (FEMS)
submitted Maintenance Maintenance Section office
Work Request Form 5.2 Receive the document from 10 minutes Administrative Aide I
the Foreman and records (FEMS)
and files accordingly
materials are available
materials are unavailable
160
21. MPL PAG-IBIG LOAN APPLICATION
Description of Service: The Human Resource Management office is responsible for the submission of employees’ application
form for the Pag-Ibig Muti-Purpose Loan. The validity of the applied loan is upon the approval of the PAG-IBIG FUND:
8-724-4244/ contactus@pagibigfund.gov.ph. Operating Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm.
TYPE OF
TRANSACTION
WHO MAY AVAIL All NCMH regular employees who has made at least 24 monthly membership savings (MS)
Duly Accomplished Muti-Purpose Loan Application Form (MPL)
HRMO Window 4
(2) original copies
NCMH ID (front & back) with 3 Signature (1) photocopy Requesting Employee
Government ID (front & back) with 3 Signature (1) photocopy Any government agencies
Latest Monthly Pay slip (1) original copy HRMO Window 3
Landbank ATM Card (1) photocopy Requesting employee
PROCESSING PERSON
TIME RESPONSIBLE
1. Submit the 1.1 Receive 1 copy and check None 5 minutes Admin Aide III / IV
accomplished Muti- the filled-out forms with (Window 4, HRMO)
Purpose Loan attachments
Application Form with 1.2 Submit to the office of 1 day Chief, HRMO
complete attachments to Chief, HRMO for
HRMO signature and approval
1.3 Forward to the Liaison 20 minutes Admin Aide III
Officer for submission to (HRMO)
PAG-IBIG FUND (Shaw Admin Assistant II
Blvd. branch) (HOPSS)
2. Receive Multi-Purpose 2. Process the application None 5 days Pag-Ibig Personnel

Loan through Landbank (Pag-Ibig Fund
ATM card Shaw)
161
22. PAG-IBIG CONTRIBUTION ADJUSTMENT
Description of Service: The Human Resource Management office is responsible for processing the request to upgrade
membership savings (PAG-IBIG Contribution). The changes on employees Pag-Ibig contribution amount are only valid upon the
request of a regular employee. Operating Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm.
OFFICE Human Resource Management Office
TYPE OF
TRANSACTION
Duly Accomplished Authority to deduct form (2) original copies HRMO Window 4
PROCESSING PERSON
TIME RESPONSIBLE
1. Proceed to HRMO and 1.1 Receive and verify the None 5 minutes Admin Aide III / IV
submit the accomplished filled-out forms (Window 4, HRMO)
form
1.2 Forward to the Chief, 1 day Supervising
HRMO for approval Administrative Officer
(HRMO)
2. Receive adjustment 2.1 Forward to Payroll Unit None 5 minutes Admin Aide III / IV
for adjustment (Window 4, HRMO)
2.2 Process adjustment 20 minutes Administrative Aide

III (Payroll Unit,
Note: Adjustment shall be HRMO)
reflected on the next
payroll report
162
23. PROCESSING OF SALARY
Description of Service: The Human Resource Management Office is responsible for the processing of the monthly salary.
Deadline: Every 12th and 22nd of the month. Operating Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm.
OFFICE Human Resource Management Office (HRMO) / Finance Service
TYPE OF
TRANSACTION
GSIS Loan Billings GSIS
PAGIBIG Loan Billings PAGIBIG
NCMHWCC Loan Billings NCMHWCC
Electric and Water Billings (Dormitories and Staff Cottages) Facilities & Non-medical Equipment Maintenance Section
Leave Indexes Leave Unit, HRMO
TAMS Report Leave Unit, HRMO
DTR Submission Summary Leave Unit, HRMO
System Edit ERU, HRMO
Deposit Slips and/or ATM Card Photocopy of newly hired
RSP Unit, HRMO
employees
LDDAP-ADA / ADA Cash Operation Section-Disbursing Unit
PROCESSING PERSON
AGENCY ACTION FEES TO BE PAID
TIME RESPONSIBLE
HUMAN RESOURCE MANAGEMENT OFFICE
1. Encode and/or update: None 5 days Admin Aide III
a. absences (LWP) (Payroll Unit, HRMO)
b. electric & water bills
c. refunds of salaries
d. other salary deductions
e. Pag-Ibig, GSIS, NCMHQCC loans
2. Prepare, process and print regular payroll of all None 5 days Administrative Aide
employees: III (Payroll Unit,
a. processing of payroll and manual encoding of HRMO)
LWOP
b. printing of regular payroll worksheet
c. encode net pays of employees to the Landbank
program (FinDes) for ATM purposes
FINANCE SERVICE
3. Receives the payroll from HRMO and process the None 1 day Admin Officer I,
request. Admin Aide VI
(Budget Section)
4.1 Checks the details of the payroll None 20 minutes Admin Officer I,
4.2 If approved and the current fund allows, signs the Admin Aide VI,
LDDAP Accountant II, IV
4.3 Forward the payroll to the Cashier Section (Accounting Section)
5.1 Review the DV. Prepare and checks the LDDAP- None 1 day Supervising
ADA/ADAS whichever applicable Administrative Officer
163
5.2 Forward to accounting Section for review and approval (Cash Operation
with signature in the case of LDDAP-ADA mode of Section-Disbursing
payment Unit)
Admin Officer I
(Accounting Section)
6.1 For review and approval of chief of Finance Service None 1 day Chief of Finance
Service
(Finance Service
Office)
6.2 For review and approval of the Medical Center Chief II Medical Center Chief
II
(MCC Office)
7. Transmit approved LDDAP-ADA/ADA’s to Land bank None 1 day Admin Officer I
(Cashier Section)
Note: Bank credits the salary to employees’ Payroll
Account
164
24. REQUEST FOR I.T SERVICES
Description of Service: This process includes repair of malfunctioning I.T equipment, Network / Internet connectivity Trouble
shooting, and Network installation. Operating Hours: Monday to Friday; 8:00 am – 11:00 pm (No Noon Break) / Saturday to
Sunday 8:00 am – 5:00 pm.
OFFICE I.T Unit
TYPE OF
TRANSACTION
None N/A
1. Call I.T unit for the request 1.1 Receive request None 5 minutes CMT II
at local 478 or 1224 1.2 Encode request at NCMH (I.T Unit)
Ticketing System
2. Receive I.T service 2.1 For repair of None Admin Aide I / VI
malfunctioning I.T Admin Assistant II
equipment: Assess and CMT III
diagnose (I.T Unit)
a. If unit is beyond 30 minutes
repair: refer to Material
management Section
for referral outside or for
condemning
b. If unit is under 30 minutes
warranty: refer to
vendor
c. If unit is out of 2 days
warranty: perform
service repair
For Network / Internet 30 minutes

connectivity Trouble
shooting
Network Installation 1 day
2.2 Prepare service report and 30 minutes

update NCMH Ticketing
System
below
1 hour and 10 minutes If unit is beyond repair / Unit is under warranty
2 days and 40 minutes If unit is out of warranty
50 minutes Network / Internet connectivity Trouble shooting
1 day and 40 minutes Network installation

165
25. REQUEST FOR LAUNDRY SERVICES
Description of Service: Provides effective and efficient laundry services through collection of soiled linens and patients’ uniforms
and distribution/delivery of clean and serviceable linens and patients’ uniforms to the different pavilions and offices. Operating
Hours: Monday to Friday, 7:00 am – 5:00 pm and Saturday to Sunday, 7:00 am – 4:00 pm.
OFFICE Laundry Section
TYPE OF
TRANSACTION
Request for Laundry Service Sheet (1) original copy Laundry Section
1. Accomplish Request for 1.1 Pick up request and soiled None 4 hours Outsourced Laundry
Laundry Service linens and patients’ uniforms Service Staff
1.2 Count and weigh linens and Laundry Worker I / II /
For Special Laundry uniforms III
Request: (Laundry Section)
Submit request and soiled 1.3 Wash, clean, iron, and fold 2 days
linens to Laundry Section the linens and uniforms Outsourced Laundry
Service Staff
2. Receive washed, cleaned, 2. Deliver washed, cleaned, None 10 minutes Outsourced Laundry
ironed and folded linens ironed and folded linens and Service Staff /
and uniforms uniforms Administrative Aide /
Laundry Worker I / II /
For Special Laundry For Special Laundry III
Request: Pick-up washed, Request: Issue washed, (Laundry Section)
cleaned, ironed and folded cleaned, ironed and folded
linens and sign in the linens
Collection and Delivery
Sheet
END OF TRANSACTION None 2 days, 4 hours and 10 minutes
166
26. REQUEST FOR LINEN SERVICES
Description of Service: Provides effective and efficient linen services through determination/projection of the linen requirements
of the hospital and ensures its adequate supply to pavilions and offices. Operating Hours: Monday to Friday, except for holidays;
8:00 am – 5:00 pm.
OFFICE Linen Section
TYPE OF
TRANSACTION
For fabrication of new linens and request for straps, rugs,
Linen Section
and shrouds: Request and Issuance Slip (1) original copy
For mending: Request for Mending Form (1) original copy Linen Section
1. Proceed to Linen Section For fabrication of new linens: None
and submit Request Slip 1.1 Receive request 3 day – for Seamstress
1.2 Measure the design simple designs Tailor
1.3 Cut and sew the cloth as per 7 days – for (Linen Section)
design complex design
For mending: 3 days Seamstress

1.1 Receive request Tailor
1.2 sew/mend the linen/uniform (Linen Section)
For straps, rugs, and shrouds: 20 minutes Seamstress

1.1 receive request Tailor
1.2 issue the requested item (Linen Section)
and record request
2. Pick up request and sign 2. Issue the item/s None 10 minutes Seamstress
the Request and Issuance Tailor
Record sheet (Linen Section)
3 days – Fabrication of new linens

(simple design)
3 days – mending of linen/uniform
20 minutes – straps/rugs/shrouds
167
27. REQUEST FOR LOAN BALANCES
Description of Service: The Human Resource Management Office is responsible for the notation of active loan balances of all
NCMH regular employees. Operating Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm.
TYPE OF
TRANSACTION
Principal
1. Accomplished Loan Balances Slip HRMO Window 4
2. Employee’s Name and ID Number Requesting employee
Authorized Representative
1. Proof of Identification of the principal and authorized Any Government-issued IDs
representative
2. Authorization Letter Requesting employee (principal)
3. Employee’s Name and ID Number
PROCESSING PERSON
TIME RESPONSIBLE
1. Proceed to Window 4, 1.1 Receive and verify the ID/ None 5 minutes Admin Aide III / IV
HRMO and submit the proof of identification (Window 4, HRMO)
accomplished Loan 1.2 Notate all the Loan
Balances Slip and Balances of the
NCMH employee ID for requesting employee/s
verification
Note: Employees
(principal) shall provide
authorization letter if
unable to personally
request for the loan
balances
2. Receive the 2. Issues the Loan Balances None 5 minutes Admin Aide III / IV
accomplished slip with Slip (Window 4, HRMO)
Loan Balances
168
28. REQUEST FOR MEMO/ HOSPITAL ORDER, AND OTHER ISSUANCES
Description of Service: This process covers from the request and issuances of Memorandum Orders and Hospital orders and
other necessary issuances. Operating Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm.
TYPE OF
TRANSACTION
Approved request for Hospital Order or Memorandum (1)
MCC Office
original
Certificate of attendance (if applicable) (1) photocopy Organizing Committee of Convention/Seminar
PROCESSING PERSON
TIME RESPONSIBLE
1. Forward the HO/Memo 1. Receive and approve None 1 day Admin Officer I
request to the MCC II the request MCC II
office for approval (MCC Office)
2. Receive approved 2.1 Draft the HO/Memo None 2 days Supervising

request and submit to 2.2 Facilitate signing of H.O Administrative Officer
HRMO a. Chief, HRMO
b. Chief, HOPSS Administrative
c. MCC II Assistant II
(HRMO)
SAO
Chief, HOPSS
MCC II
3. Receive the official 3. Release H.O / Memo via None 1 minute Admin Aide I
HO/Memo email and hardcopy Admin Assistant II
(HRMO)
169
29. REQUEST FOR MONTHLY PAYSLIP
Description of Service: The process of releasing of employee’s Monthly payslips every 3rd week of the following month. Operating
Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm.
TYPE OF
TRANSACTION
Principal
Employee’s Name and ID Number Requesting Employee
Authorized Representative
4. Proof of Identification of the principal and authorize Any Government-issued IDs
representative
6. Employee’s Name and ID Number
PROCESSING PERSON
TIME RESPONSIBLE
1. Proceed to HRMO- 1. Receive and check None 2 minutes Admin Aide III / IV
Payroll Unit and submit Identification (Payroll Unit, HRMO)
NCMH Employee I.D
Present proof of
Identification of the
principal and authorize
representative together
with the Authorization
Letter
2. Receive payslip and sign 2. Issue payslip None 3 minutes
on the Request Logbook Admin Aide III / IV
(Payroll Unit, HRMO)
170
30. REQUEST FOR PHILHEALTH CONTRIBUTION
Description of Service: The Human Resource Management office is responsible for the preparation and releasing of the
Employees PhilHealth Contribution. This Certification is only issued upon the request of a regular employee. Operating Hours:
Monday to Friday, except for holidays; 8:00 am – 5:00 pm.
TYPE OF
TRANSACTION
Employee’s Name and ID Number Requesting employee
PROCESSING PERSON
TIME RESPONSIBLE
1. Proceed to HRMO 1.1 Receive and verify the I.D None 2 minutes Admin Aide III / IV
window 4 and present (Window 4, HRMO)
employee ID
1.2 Prepare the certificate 30 minutes Admin Officer II
(HRMO)
Supervising
1.3 Sign the certificate 1 day Administrative Officer
(HRMO)
2. Receive certificate and 2. Issue certificate None 3 minutes Admin Aide III / IV
sign on the log sheet (Window 4, HRMO)
171
31. REQUEST FOR SANITATION WORKS
Description of Service: The Sanitation Section conducts different housekeeping, janitorial, and sanitary job requested by the
NCMH employees. Operating Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm (No Noon Break).
OFFICE Sanitation Section
TYPE OF
TRANSACTION
Sanitation Work Request Form (1) original copy Sanitation Section
1. Accomplish Sanitation 1.1 Receive Sanitation Request None 5 minutes Admin Aide I / III
Work Request form and form and endorse to the Hospital Housekeeper
submit to Sanitation concerned unit (Sanitation Section)
Section 1.2 Schedule the requested
work and inform the 5 minutes
requesting office
2. Receive request of 2. Conduct the requested work None 30 minutes Hospital Housekeeper
service (Sanitation Section)
3. Sign and submit the 3.1 Receive Sanitation Work None 5 minutes Hospital Housekeeper
Sanitation Work Request request (Sanitation Section)
3.2 Record and file Sanitation
Work request 5 minutes Admin Aide I / II
(Sanitation Section)
172
32. REQUEST FOR SECURITY ASSISTANCE
Description of Service: Security Section provides assistance to service users and stakeholders. Operating Hours: The service
OFFICE Security Section
TYPE OF
TRANSACTION
None N/A
1. Call the Security Office 1. Acknowledge the call and None 2 minutes Security Guard I, II, III
for security assistance gather the information/ (Security Section)
details of the concern
2. Wait for the arrival of the 2. Immediately provide None 3 minutes Security Guard I, II, III
responder Security Personnel for (Security Section)
proper assistance on the
area
173
33. REQUEST FOR TRANSPORT SERVICES
Description of Service: Transport assistance is provided by NCMH-Motorpool to all service-users and employees wherein request
is approved in accordance with the existing guidelines. Operating Hours: The service is available 24/7, provided that trip ticket is
accomplished properly.
OFFICE Transport Section
TYPE OF
TRANSACTION
Trip Ticket (4) original copies Transport Section
Court Order (if the purpose of the trip is to attend court hearing) Service User
1. Accomplish four (4) copies 1.1 Receive and check the None 5 minutes Admin Aide III
of trip ticket and submit to completeness of the trip Admin Assistant II
Transport Section ticket (Transport Section)
1.2 Log the trip ticket on the
vehicle dispatch record and
Ensure that the trip ticket put a series number in the
shall be done one (1) day trip ticket
before the scheduled trip
1.3 Approve trip ticket 3 hours Chief Admin Officer
(HOPSS)
1.4 Matching and scheduling of 40 minutes Admin Aide III

vehicles and drivers Admin Assistant II
1.5 Confirmation of scheduled (Transport Section)
trips
2. Receive notification request 2. Dispatch corresponding None 15 minutes Admin Aide III
approval vehicle with driver Admin Assistant II
(Transport Section)
END OF TRANSACTION None 4 hours
174
34. REQUISITION OF SERVICE RECORD AND CERTIFICATE OF EMPLOYMENT
Description of Service: The Human Resource management Office is responsible for the processing and releasing of Certificates
and Service Record upon request of NCMH employees. Operating Hours: Monday to Friday, except for holidays; 8:00 am – 5:00
pm.
Simple – Service Record TYPE OF
CLASSIFICATION Complex-Certificate of G2G – Government to Government
TRANSACTION
Employment
WHO MAY AVAIL All current and separated employees of NCMH
Principal:
1. Request Form (1) original copy HRMO Window 2
2. Official Receipt Collection and Deposit Unit (Pavilion 2)
Authorized Representative:
1. Proof of Identification of the principal and authorized Any Government-issued IDs
representative
3. Request Form (1) original copy HRMO Window 2
4. Official Receipt Collection and Deposit Unit
PROCESSING PERSON
TIME RESPONSIBLE
1. Proceed to HRMO and 1. Issue request slip and None 3 minutes Admin Assistant II
accomplish request charge slip (Employee Relations
slip and Transactions
Unit, HRMO)
2. Proceed to Collection 2. Process the payment See schedule of 10 minutes Administrative Officer
and Deposit Unit and and issue official receipt fees below III (Collection and
provide amount to be Deposit Unit)
paid
3. Return to HRMO and 3.1 Receive and check None 35 minutes Admin Assistant II
present the official request slip for (Employee Relations
receipt and request completeness of and Transactions
slip information Unit, HRMO)
3.2 Process the request
4. Receive the requested 4. Release the duly signed None 2 minutes Admin Assistant II
document document/ certification (Employee Relations
5 working days and Transactions
COE Unit, HRMO)
3 working days
Service Record
Php 30.00 – Active
NCMH Employee
Php 100.00 –
Inactive NCMH
Employee 5 days – Certificate of Employment
END OF TRANSACTION
3 days – Service Record
FREE -
Certificate/Service
Record for COVID
claims purposes
only
175
35. RFID APPLICATION
Description of Service: The Security Section processes and issue the RFID application of all qualified NCMH Employees.
Operating Hours: Monday to Friday, except for holidays; 8:00 am - 5:00 pm (No Noon Break).
OFFICE Security Section
TYPE OF
TRANSACTION
RFID Application Form (2) original copies Security Office
Employee’s ID (2) photocopies To be provided by the applicant
Valid Driver’s License (2) photocopies To be provided by the applicant
Updated O.R. & Certificate of Registration (CR) of the vehicle.
In case that the vehicle is not yet transferred in the name of the
To be provided by the applicant
Employee/Execom, notarized Deed of Absolute Sale is required
(2) photocopies
If parent, children or spouse: Birth Certificate / Marriage
To be provided by the applicant
Contract to established relationship (2) photocopies
For Contractual and Consultant: Contract of
Service/Consultancy shall be required as additional documents To be provided by the applicant
(2) photocopies
1. Secure RFID application 1. Issue 2 copies of application None 1 minute Security Guard I / II
form at the Security Office form (Traffic and Parking
Management)
2. Fill out the form and 2.1 Receive requirements and None 2 minutes Security Guard II
submit application and check application form for (Security Section)
other requirements to the completeness of data
Security Office 2.2 Process the application 2 days Security Officer III
(Security Section)
3. Wait for the notification 3.1 Receive and review None 3 minutes Senior Administrative
from COS approved Application Form Officer (COS)
3.2 Endorse to Cash Operation
Section (COS) for RFID
Installation
4. Bring registered vehicle 4.1 Install the RFID to the None 4 minutes Senior Administrative
for RFID installation approved vehicle Officer (COS)
4.2 Return to the Security Office
the completed and installed
Application Form
176
36. APPLICATION FOR BOND OF ACCOUNTABLE PUBLIC OFFICER
Description of Service: To comply with the requirement set by the Commission on Audit Circular No. 2012-001 to those Officers
and Employees that will have hold Cash Advance.
TYPE OF
TRANSACTION
WHO MAY AVAIL NCMH Employees required to be bonded
Duly Accomplished Form 3: Annex D – Fidelity Bond
Accounting Section
Application Form
Latest 2x2 Picture (1) copy Requesting Party
Valid government issued I.D except NCMH ID (1) photocopy Requesting Party
Latest SALN (1) photocopy Requesting Party
Appointment (1) photocopy Requesting Party
Hospital Order authorizing to handle Cash Advance HRMO
1. Proceed to Accounting 1.1 Receive and check the None 1 hour Admin Officer IV
Section and submit the documents Accountant IV
required documents 1.2 Prepare and process the list (Accounting Section)
for Bond of Accountable
Officers and Employees
1.3 Present approved Authority
to Accept Payment (ATAP)
to LBP for payment of Bond
Premium
1.4 Present Validated Deposit
Slip (Check) and ATAP as
proof of payment
2. Receive confirmation 2. Release the Confirmation None 5 minutes Admin Officer IV
letter Letter forwarded by the (Accounting Section)
Bureau of Treasury
177
37. ISSUANCE OF CERTIFICATION OF AVAILABILITY OF FUNDS (CAF)
Description of Service: The Budget Section facilitates the processing of Certification of Availability of Funds (CAF). Operating
Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm.
OFFICE Budget Section
TYPE OF
TRANSACTION
Request for CAF Procurement Section
Purchase Request/ Hospital order/ Abstract of Canvass/
To be provided by the end-user
Quotation
1. Proceed to Budget Section 1. Receive and verify None 5 minutes Admin Assistant III
and submit CAF Request documents (Budget Section)
form with Purchase
Request/ Hospital Order/
Abstract of Canvass/
Quotation
2. If funds are sufficient, None 5 minutes Admin Officer I
process Certificate of (Budget Section)
Availability of Funds (CAF)
3. Review and sign CAF and None 5 minutes Supervising

forward to the Accounting Administrative Officer
Section (Budget Section)
4. Sign CAF and forward to the None 1 day Accountant IV

Chief of Finance Service for (Accounting Office)
final approval
5. Approve CAF and forward to None 1 day Chief of Finance

Procurement Section for Service
proper disposition (Finance Service)
178
38. LATE FILING OF BIR FORM 2316
Description of Service: The Accounting Section is responsible for the issuance of BIR Form 2316 to all NCMH employees.
Operating Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm.
TYPE OF
TRANSACTION
1. Proceed to Accounting 1.1 Verify that BIR Form 2316 None 20 minutes Admin Officer I
Section to request for BIR was indeed unclaimed by Accountant IV
Form 2316 the requesting party (Accounting Section)
1.2 Issue charge slip
2. Proceed to Collection and 2. Receive the payment and Php1,000.00 10 minutes Admin Officer III
Deposit Unit and provide issue official receipt (Collection and
the amount to be paid Deposit Unit)
3. Return to Accounting 3. Check the official receipt None 5 minutes Admin Officer I
Section and present Accountant IV
official receipt (Accounting Section)
4. Receive BIR Form 2316 4. Release BIR Form 2316 None 5 minutes Admin Officer I
Accountant IV
END OF TRANSACTION Php1,000.00 40 minutes
179
39. PER DIEM CLAIMS
Description of Service: The Accounting Section is responsible for the processing of per diem claims of the qualified NCMH
employee. Operating Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm.
TYPE OF
TRANSACTION
PER DIEM CLAIMS
Hospital Order (1) photocopy Office of the Director / HRMO
Duly Accomplished Itinerary of Travel (1) original copy COA Website
Duly Accomplished Certificate of Travel Completed (1) original
COA Website
copy
Duly Accomplished Disbursement Voucher (2) original copies COA Website
Duly signed Trip Ticket, one (1) photocopy Transportation Section
Home Conduction:
Duly Accomplished List of Patient (1) original copy Medical Social Service - Malasakit
Duly Accomplished Discharge Slip Medical Social Service - Malasakit
Court Hearings:
Certificate of Appearance Court of Law
1. Proceed to Accounting 1.1 Receive and check the None 2 days Admin Aide III / VI
Section and submit all the submitted documents Accountant III / IV
necessary requirements If complete: process the (Accounting Section)
request
If incomplete: return the

documents for completion
1.2 Forward the processed

documents to the HRMO-
Payroll Unit
2. N/A 2. Receive and process the per None 1 day Admin Aide III (Payroll
diem claims and forward to Unit, HRMO)
the Budget Section
3. N/A 3. Receive the payroll from None 1 day Admin Assistant III
HRMO and process the (Budget Section)
request then submit to
Accounting Section
180
4. N/A 4.1 Check the details of the None 20 minutes Admin Aide III / VI
payroll. If approved and the Accountant III / IV
current funds allows, sign (Accounting Section)
the LDDAP
4.2 Forward the payroll to the
Cashier Section
5. N/A 5.1 Process the DV for payment None 1 hour Admin Officer I
5.2 Forward to the Accounting (Cashier Section)
Section the LDDAP
6. N/A 6.1 Check the details of the None 15 minutes Admin Aide VI
LDDAP and record the Admin Officer I
amount of the transaction to (Accounting Section)
the monitoring file
6.2 Sign the LDDAP Accountant III / IV
6.3 Return the signed LDDAP to (Accounting Section)
the Cashier Section
7. Receive claims 7. Process the payment of the None 1 hour Admin Officer I
LDDAP (Cashier Section)
END OF TRANSACTION None 4 days, 2 hours, and 35 minutes
181
40. REPLENISHMENT OF PETTY CASH FUNDS / LIQUIDATION OF PETTY CASH FUNDS
AND CASH ADVANCES / REIMBURSEMENT OF EXPENSES
Description of Service: The Accounting Section is responsible for the processing of replenishment of petty cash funds, liquidation,
and reimbursement of expenses. Operating Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm.
TYPE OF
TRANSACTION
Duly Accomplished Obligation Request and Status or Budget
Utilization Report Status (4) original copies. (If Liquidation is COA Website
with Reimbursement)
Duly Accomplished Disbursement Voucher (2) original copies (if
COA Website
Liquidation is with Reimbursement)
Duly Accomplished Purchase Request/s COA Website
Summary of Tax Withheld from Suppliers Requesting Party
Duly Accomplished Inspection and Acceptance Report COA Website
Such other supporting documents that may be required and/or
required under the company policy depending on the nature of
expenses (COA Circular No. 2012-001)
Purchases of P1,000.00 and above:
Duly Accomplished Price Quotations (at least from 3 suppliers) Requesting Party
Duly Accomplished Abstract of Canvass Requesting Party
Purchase of Goods:
Duly Accomplished Sales Invoice (Original & Photocopy) Supplier
Inventory Custodian Slip (if item bought is a Semi-Expendable
COA Website
Asset)
Purchase of Services:
Duly Accomplished Official Receipt (Original & Photocopy) Supplier
PETTY CASH FUND REPLENISHMENT
Duly Accomplished Tax Voucher (2) copies COA Website
Duly Accomplished Reimbursement Expenses Receipt/s COA Website
Duly Accomplished Certificate of Expenses Not Requiring
COA Website
Receipt/s
Summary of Tax Withheld from Suppliers Requesting Party
Duly Accomplished Petty Cash Voucher/s COA Website
Duly Accomplished Petty Cash Fund Record COA Website
Duly Accomplished Paid Petty Cash Vouchers COA Website
LIQUIDATION OF PETTY CASH FUND
Liquidation Report COA Website
Official Receipt from Collecting Section (if with excess Cash) Collection and Deposit Unit
Requirement Nos. 2-7 of the PCF Replenishment Various
182
LIQUIDATION OF CASH ADVANCES
Liquidation Report COA Website
Official Receipt (if with excess Cash) Collection and Deposit Unit
Duly Accomplished Report of Cash Disbursement Requesting Party
Requirement Nos. 2-4 of the PCF Replenishment Various
REIMBURSEMENT OF EXPENSES
Hospital Order HRMO
Duly Accomplished Tax Voucher (2) copies COA Website
Summary of Expenses Requesting Party
Requirement Nos. 2-3 of the PCF Replenishment
Training / Seminar Attended:
Certificate of Completion, Attendance or Participation Training / Seminar Provider
Approved Training Request Form PETRO
Training/Seminar Invitation Training / Seminar Provider
Duly Accomplished Itinerary of Travel (if Applicable) COA Website
Trip Ticket, one (1) photocopy (if Applicable) Transportation Section
Duly Accomplished Certificate of Travel Completed (if
COA Website
Applicable)
Transportation Documents (if Applicable) Service Provider
1. Submit the DV with all its 1.1 Receive and check the None 10 minutes Admin Assistant III
supporting documents to documents Admin Officer I
the Budget Section 1.2 Process the request (Budget Section)
2. N/A 2.1 Receive and review the None 5 minutes Admin Aide III/ IV
request Admin Officer I/ III/ IV
(Accounting Section
2.2 Approve (for signature of 1 day Accountant III / IV

DV) or disapprove the (Accounting Section)
request
If approved and the current 10 minutes Admin Aide III/ IV

budget allows, forward the Admin Officer I/ III/ IV
documents to the Cashier (Accounting Section)
Section
If disapproved, explain the 30 minutes

deficiencies noted to the
requesting party
183
3. Receive the check from the 3. Process the DV for None 1 hour Admin Officer I
Cashier Section payment. (Cashier Section)
If thru bank
deposit/transfer, prepare
and forward to the
Accounting Section the
LDDAP
If thru a check, prepare the
check and issue the same to
the requesting party
LDDAP and record the Admin Officer I/ III
the monitoring file
4.2 Sign the LDDAP
4.3 Forward the signed LDDAP Accountant III/ IV
to the Cashier Section (Accounting Section)
5. Receive petty cash fund/ 5. Process the payment of the None 1 hour Admin Officer I
reimbursement of expenses LDDAP (Cashier Section)
END OF TRANSACTION None 1 day, 3 hours, and 10 minutes
184
41. REQUEST FOR PETTY CASH FUND AND CASH ADVANCE
Description of Service: In order to have a safeguard in place, DV supporting documents / attachments must be scrutinized as to
its overall soundness. Operating Hours: Monday to Friday, except for holidays; 8:00 am – 5:00 pm.
TYPE OF
TRANSACTION
Hospital Order HRMO
Certification from the Accountant that previous cash advances
Accounting Section
have been liquidated and accounted for in the books
Duly Accomplished Obligation Request and Status or Budget
COA Website
Utilization Report Status (4) original copies.
Duly Accomplished Disbursement Voucher (2) original copies. COA Website
Approved application for bond and/or Fidelity Bond for the year
Accounting Section
for the cash accountability of P2,000.00 or more.
PETTY CASH FUND SPECIFIC
Approved estimates of petty expenses for one (1) month Requesting Party
CASH ADVANCE SPECIFIC
Summary estimate of expected expenses Requesting Party
Special Seminars / Trainings to be conducted by private
entity/ies
Invitation from the training provider Private Training Provider
Approved Training Request Form PETRO
DOH Training / Seminar
Department Personnel Order Department of Health
1. Submit the DV with all its 1. Receive and check None 10 minutes Admin Assistant III
supporting documents to documents Admin Officer I
the Budget Section Process the request and (Budget Section)
forward to Accounting
Section
2. N/A 2.1 Review documents None 1 day Admin Aide III / VI
submitted Admin Officer I / III/ IV
2.2 Approve (for signature of
DV) or disapprove the Accountant III / IV
request (Accounting Section)
If denied, explain the
deficiencies noted to the
requesting party
If approved and the current
budget allows, forward the
documents to the Cashier
185
Section
3. Receive the check from 3. Process the DV for payment None 2 hours Admin Officer I
the Cashier Section (Cashier Section)
If thru bank deposit/transfer,
prepare and forward to the
Accounting Section the
LDDAP
If thru a check, prepare the

check and issue the same to
the requesting party
LDDAP and record the Admin Officer I
the monitoring file
4.2 Sign the LDDAP Accountant III / IV
5. Receive the petty cash 5. Process the payment of the None 10 minutes Admin Officer I
advance LDDAP (Cashier Section)
END OF TRANSACTION None 1 day, 2 hours, and 35 minutes
186

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NCMH CTZ Charter 2023 5

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REPUBLIC OF THE PHILIPPINES

NATIONAL CENTER FOR MENTAL HEALTH

IV. Service Pledge

AGENCY PROFILE PAGE

SERVICES UNDER THE MEDICAL CENTER CHIEF OFFICES

1. Application for Clinical Rotation for Student Affiliates 7

PATIENT CARE SERVICES

14. Admission Process for Non-Psychiatric Patients 25

MEDICAL ANCILLARY SERVICES PAGE

35. Accessing Health Care Information of In-Patients and Out-Patients 65

HOSPITAL OPERATIONS AND PATIENT SUPPORT SERVICES

62. Hiring Process 114

64. Processing of BIR Form 2307 126

SERVICES UNDER THE MEDICAL CENTER CHIEF OFFICES PAGE

1. Application for Advanced Professional Courses 133

MEDICAL ANCILLARY SERVICES

11. Application for COVID-19 Sickness and Death Compensation for

HOSPITAL OPERATIONS AND PATIENT SUPPORT SERVICES

13. Appointment Process 150

FINANCE SERVICE PAGE

36. Application for Bond of Accountable Public Officer 177

AFFILIATION FEE AMOUNT

Application letter addressed to the Medical Center Chief Applicant

END OF TRANSACTION None 17 days and 50 minutes

Complaint Letter Client

FEES TO PROCESSING PERSON

CSC Contact Center ng

2.3 Prepare and submit final None 1 hour Nurse II, IV

3.2 Concerned agency will Concerned agency

1.3 If the written Complaint is

1.4 Upon finding of probable

1.5 Upon signature of the MCC,

B. Courier/Personal B. Check/screen/ receive

Invitation/Letter of Request Respective individual stakeholders, agencies, organizations,

2.2 Evaluate the feasibility of the Nurse I /Program

2.4 Approval of the Specific Unit Head

3.2 Implementation of the action Nurse I / Program

4.4 MOU forwarded to MCC for 3 days Medical Center Chief

4.5 Notarization of MOU 1 day Admin Assistant II

END OF TRANSACTION None 26 days

1.3 Approve or disapprove the None 1 hour

END OF TRANSACTION None 6 days, 1 hour and 10 minutes

OFFICE Professional Education, Training, and Research Office (PETRO)

1.2 Receive and assess nature None 2 hours Nurse I

2.2 Issue the documents to the None 1 hour DOH-KMITS

END OF TRANSACTION None 14 days

2.2 Evaluate the feasibility of the Nurse I / II

2.3 Prepare/formulate an action Nurse I / II

2.4 Approval of the Nurse II / HEPO III

3.2 Implementation of the action Nurse I / II

5. Receive training 5. Conduct training None 2 days – BLS Nursing Attendant II

11 days and 10 minutes – BLS Training

If pass with minor

If pass with major

If fail: Submit new

4.2 Affix signature 2 days Technical Review

5. Receive approval clearance 5. Release clearance None 10 minutes Admin Officer II

END OF TRANSACTION None 6 days, 1 hour, and 45 minutes

5. Proceed to ward 5.1 Transfer and endorse None 20 minutes Nurse I / II

END OF TRANSACTION None 2 hours and 40 minutes

RATE FOR ADMISSION AMOUNT

3. Undergo physical 3.1 Conduct physical None 20 minutes Nurse I / II

4. Proceed to ward 4.1 Transfer and endorse None 20 minutes Nurse I / II