Home  »  Government ServicesJuander HowPhilHealth   »   How To Fill Out PhilHealth Form (With Pictures)

How To Fill Out PhilHealth Form (With Pictures)

How To Fill Out PhilHealth Form (With Pictures)

Do you need to register with PhilHealth or update your existing membership information? You need to submit a duly-accomplished PhilHealth Member Registration Form (PMRF) for that. Here’s a step-by-step guide on how to fill it out. 

Disclaimer: This article has been published for educational purposes only. Neither the author nor FilipiKnow is affiliated with PhilHealth, so specific queries about your membership and insurance benefits must be forwarded to the proper authority.

Table of Contents

Steps in Filling Out the PhilHealth Member Registration Form (PMRF)

1. Download the Updated PMRF From the PhilHealth Website

how to fill up philhealth form 1

To access and download the latest PMRF, go to the official PhilHealth website, select “downloads” from the main menu, click on “Forms,” and finally, click the “PMRF: PhilHealth Member Registration Form” link to open the PDF document in a new tab. 

Click the download icon to save a copy on your computer.

2. Provide All the Required Information in the Space Provided

a. Your 12-digit PhilHealth identification number


b. Purpose: Select “Registration” if applying as a new member and “Updating/Amendment” if for an update of membership information

how to fill up philhealth form 3

c. Full name and name of spouse if married

how to fill up philhealth form 4

d. Date (MM/DD/Y) and Place of Birth (City/Municipality/Province/Country), Sex (Male or Female), Civil Status (Single/Married/Legally Separated/Annulled/Widow/er), Citizenship (Filipino/Dual Citizen/Foreign National)

how to fill up philhealth form 5

e. PhilSys ID Number (optional) and TIN Number (optional)

how to fill up philhealth form 6

f. Permanent Home Address and Mailing Address, Contact Information (Home Number, Business Number, Mobile Number, Email Address)

how to fill up philhealth form 7

g. Indicate your dependents in the Dependents section of the form.

how to fill up philhealth form 8

h. Select Member Type and indicate current profession and income

how to fill up philhealth form 9

To help you determine where you belong, here’s a table summarizing the different types of PhilHealth membership:

Direct Contributors (income generating and pays premiums)Indirect Contributors (subsidized by the government)
Employees with formal employmentIndigents identified by the DSWD; beneficiaries of Pantawid Pamilyang Pilipino Program
KasambahaysSenior citizens
Self-earning individuals; professional practitioners (These individuals are not hired by an employer but earn their income by offering their services)Persons with disability
Overseas Filipino Workers (This category covers land-based migrant workers, seafarers, Filipinos living or working abroad that are not citizens of that country, and overseas Filipinos in distress)Sangguniang Kabataan officials
Filipinos living abroad and those with dual citizenshipPreviously identified at point-of-service/sponsored by LGUs
Lifetime membersFilipinos aged 21 years old and above without capacity to pay premiums
All Filipinos aged 21 years and above with the capacity to pay

i. Updating or Amendment: Indicate the information you want to change. Put in the information prior and the updated information in the corresponding columns.

how to fill up philhealth form 10

j. Signature or Thumb Mark: Do not forget to sign the PMRF. If unable to write, a thumbmark can also suffice.

how to fill up philhealth form 11

Return to the main article: How To Register in PhilHealth Online: A Complete Guide for New Members

Camille Lamera, MD

Camille Lamera is a medical doctor with clinical and government work experience. She has always been passionate about health education and public service, having worked in two government offices and as a part-time educator in Preventive and Community Medicine. She is currently working as a doctor in public health while also doing freelance academic and scientific writing.

Browse all articles written by Camille Lamera, MD

Copyright Notice

All materials contained on this site are protected by the Republic of the Philippines copyright law and may not be reproduced, distributed, transmitted, displayed, published, or broadcast without the prior written permission of filipiknow.net or in the case of third party materials, the owner of that content. You may not alter or remove any trademark, copyright, or other notice from copies of the content. Be warned that we have already reported and helped terminate several websites and YouTube channels for blatantly stealing our content. If you wish to use filipiknow.net content for commercial purposes, such as for content syndication, etc., please contact us at legal(at)filipiknow(dot)net

FILIPIKNOW® is a registered trademark of the owner of Pacific Pact with Registration No. 4/2019/00504365. All content is copyrighted.
Terms of Service & Privacy Policy About Filipiknow Facts & Figures