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Authorization

Domingo F. Fulleros authorizes his son, David F. Fulleros, to act on his behalf regarding all Philhealth matters. David is permitted to access information about Domingo's membership and make decisions in his best interests. The authorization is supported by attached identification and a specimen signature.

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Ella Mae Fulleros
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15 views1 page

Authorization

Domingo F. Fulleros authorizes his son, David F. Fulleros, to act on his behalf regarding all Philhealth matters. David is permitted to access information about Domingo's membership and make decisions in his best interests. The authorization is supported by attached identification and a specimen signature.

Uploaded by

Ella Mae Fulleros
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Domingo F.

Fulleros
Madlawon, Bulusan, Sorsogon
November 21, 2023

Metro Health Specialists Hospital

Diversion Road, Cabid-an Sorsogon City, Sorsogon

To Whom It May Concern:

I, DOMINGO F. FULLEROS, a member of Philhealth with membership number 10-


000052881-6, hereby authorize my son DAVID F. FULLEROS to act on my behalf to all my
Philhealth matters.
DAVID F. FULLEROS is authorized to access information regarding my Philhealth
membership. I trust him to perform any task on my behalf and make decisions in my best
interests.
Attached here are the photocopy of my valid id and my specimen signature as proof of my
consent and authorization.

Thank you for understanding this matter.

Yours truly,
Domingo F. Fulleros

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