• Hostel Guest Form

    Hostel Guest Form

    Consent and Authorization for Processing of Personal and Sensitive Personal Information
  • Current Date
     / /
    2 digit month, 2 digit day, 4 digit year

  • We at THE MEDICAL CITY are committed to maintaining the confidentiality of your care by ensuring that safeguards are in place to protect your personal health information and keep it safe and secure.

    DATA PROCESSING

    We process your personal and sensitive personal information (collectively, “information”) to provide you with efficient and effective healthcare management. Information we collect may include your:

    1. Name, age, sex, birthday, nationality, citizenship, religion, occupation, current employment, address, email address, telephone/mobile number;
    2. Medical diagnoses;
    3. Past and current medications or treatments;
    4. Past and current medical history, including where relevant, a family medical history;
    5. Diagnostics and laboratory tests;
    6. Father’s and mother’s details, spouse details and personal information of person/ parties responsible for your account; and,
    7. Any other information that will assist us in providing you with better health care

    To the extent permitted or required by law, we use your information to pursue our legitimate interests as a teaching hospital for treatment, training, research, administrative, and statistical purposes. This includes, but is not limited to the following:

    1. Sharing your information with the members of the healthcare team through different communication platforms to coordinate and give you treatment and care;
    2. Collecting, billing, and receiving payment for the services rendered to you;
    3. Performing and accomplishing our health care operations and processes;
    4. Maintaining quality assurance and patient safety programs for the improvement of our health services and compliance with standards of care;
    5. Using anonymized/de-identified health information by TMC physicians, researchers and allied medical staff to help advance medical knowledge in the Philippine;
    6. Contracting with outside entities for components of our healthcare and professional services such as the Joint Commission International, government entities, billing companies, management consultants, accounting or legal firms and quality assurance reviewers; and
    7. Complying with the laws, issuances and reportorial obligations that govern healthcare such as but not limited to the Cancer Registry, Rare Disease Registry, TB Registry, and HIV/AIDSWatch.

     

    DATA PROTECTION

    We implement reasonable and appropriate organizational, physical, and technical security measures for the protection of personal data which we collected. These security measures aim to maintain the availability, integrity, and confidentiality of personal data and are intended for the protection of personal data against any accidental or unlawful destruction, alteration, and disclosure, as well as against any other unlawful processing.

    CONFIDENTIALITY

    Our doctors and employees operate and hold personal and sensitive personal information under strict confidentiality. They are required to sign non-disclosure agreements and have received training on the company's privacy and security policies to ensure confidentiality and safety of personal data.

    CONFORME

    I have read and understood this Consent and Authorization for Processing of Personal and Sensitive Personal Information and express my consent for The Medical City to process of my personal and health information for the purposes stated above. I understand that my consent does not preclude the existence of other criteria for lawful processing of personal data and does not waive any of my rights under the Data Privacy Act of 2012 and other applicable laws.

  • The Medical City is dedicated to providing you with efficient and quality service. To meet these goals, we need your consent for participation to the following programs. Please choose if you wish to participate. Should there be other processes and projects that will entail processing of your information, a separate consent will be taken for these.

    PROGRAM DESCRIPTION
    Continuity of Care
    (Post Hospitalization
    Services under PSI Health,
    an affiliate of The Medical
    City)     		To ensure smooth transition of patient care from the hospital to the home, our dedicated partner, Prosync, will call you for reminders regarding home instructions such as your follow-up schedule with doctors, prescribed diet, physical activities, home care plan, things to watch out for and necessary diagnostic procedures.
    Research Program Research is essential in advancing medical knowledge. By participating, TMC may communicate with you to discuss possible participation in research activities, or donation of your excess tissue or body fluids (if available) for examination. To the extent possible, your personal information will be anonymized or de-identified. Any research will undergo review and approval by TMC's Institutional Review Board.
    Telesurvey (Patient
    Experience Feedback)     		As part of our continuous initiatives to improve the quality of our services, we collect patient experience feedback through our telesurvey partner, Prosync.
    Marketing
    Communications     		The Medical City prides itself on keeping abreast with the latest technology, programs, and treatment plans. Patients may receive marketing materials through mail, texts, and emails from The Medical City regarding program or service updates and promotions
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  • Hostel Guest Form

    Hostel Guest Form

    Guest Information Sheet
  • Please choose*
  • Date of Accommodation*
     / /
    2 digit month, 2 digit day, 4 digit year
  •  / /
    2 digit month, 2 digit day, 4 digit year
  • Birth Date*
     / /
    2 digit month, 2 digit day, 4 digit year
  • Gender*
  • Civil Status (Hidden)

  • ADDITIONAL INFORMATION

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  • Hostel Guest Form

    Hostel Guest Form

    Guest Information Sheet

  • OTHER INFORMATION

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  • COMPANION INFORMATION

  • PATIENT INFORMATION

  • Birth Date
     / /
    2 digit month, 2 digit day, 4 digit year
  • Gender
  • In compliance with the Data Privacy Act of 2012, The Medical City ensures that the information you provide will be kept strictly confidential and only be processed, disclosed, or shared upon your consent or as required by law.
  • Hostel Guest Form

    Hostel Guest Form

    Hostel Checklist Upon Check-in

  • It is our pleasure to take care of you while billeted in our Hostel. For your comfort and convenience, you are entitled to the following amenities:

    • Complimentary daily set breakfast
    • Complimentary two (2) bottled water, replenished daily
    • Exclusive check-in and check-out (Check-in time is at 2:00 PM and Check-out time is at 12:00 NN)
    • Wi-Fi internet connection
    • Microwave oven, air pot, and refrigerator are provided at the Food and Beverage room for your use

    For your safety and security, please be guided by the following:

    • Keep your door locked and bring your key with you at all times
    • Refrain from leaving large amount of cash and valuables in the room. Safety deposit boxes are available at the Admission and Bed Management Department for a minimal fee
    • Do not entertain suspicious telephone calls. All incoming calls received from outside the hospital are screened by the Center for Patient Experience Department. If you are unsure of the veracity of the call, please report this immediately to us
    • In case of any Emergency, please dial LOCAL 4.

    We would like to inform you of the following guidelines

    • The Hostel shall be available for use of foreign Guests and other patient's relative.
    • A maximum of two (2) persons shall be allowed to stay in the room. Children seven (7) years old and below are prohibited to stay in the room. Parents requesting accommodations for children in this bracket will be required to accomplish a special WAIVER Form
    • Other extra amenities requested by the guests will be charged with a nominal fee
    • A deposit equivalent to one night's stay shall be required upon check-in or pay the equivalent length of your stay.
    • A security deposit equivalent to one night's stay shall be required upon check-in but this will be refunded upon check-out if there is no damage and loss of Hostel property.
    • The entire hospital complex is a non-smoking facility. Any violation of this policy is subject to an applicable fine.
    • Each of our rooms are equipped with the "Building Awesome Pillow Forts/ Tidy Up My Room" signage. When "Building Awesome Pillow Forts" is placed at the door, your room shall not be cleaned, however, if "Tidy Up My Room" is placed, this means that you are fully consenting housekeeping staff to enter and clean your room.
    • Visitors are allowed from 7:00AM-10:00PM. Your visitor/s that prefers to stay longer would be requested to occupy another room with the applicable charges.
    • Bringing in pets is not allowed.
    • Giving tips to hospital personnel is strictly prohibited.


    Please feel free to let us know if you will need any assistance or simply tell us how we can make your stay more comfortable. You may reach the Hostel Reception desk at local 3203 and 3172 from 6:00 AM to 10:00 PM daily or our Center for Patient Experience at Locals 6167 and 6168, from 8:00 AM to 6:00 PM daily. Beyond our office hours, you may also dial 0 for Operator assistance or check our Hostel Services App to access our services at the comfort of your room (placed on your side table)

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