1. Medical Staff application form
2. Letter of Intent to the Medical Director / Department Chair concerned
3. Updated Curriculum Vitae
4. Photocopy of Medical/Dental School Diploma
5. Photocopy of Internship and Residency Training Certificate
6. Photocopy of Fellowship Training Certificate (if applicable)
7. Photocopy of Specialty Board Certificate
8. Photocopy of Subspecialty Board Certificate (if applicable)
9. Photocopy of current Professional Regulatory Commission (PRC) License and Board Certificate
10. Photocopy of current PhilHealth ID as accredited healthcare professional
11. Photocopy of current S2 license (if applicable)
12. BIR Form 2303
13. Photocopy of current Basic Life Support (BLS) Certificate
14. Photocopy of current ACLS (Advanced Cardiovascular Life Support) Certificate for Anesthesiology, Medicine, Emergency Medicine, Physical Medicine and Rehabilitation, Neurosurgery, Neurology and Surgery.
15. Photocopy of current PALS (Pediatric Advanced Life Support) /NALS (Neonatal Advanced Life Support) Certificate for Pediatrics
16. Two (2) pieces 2×2 ID pictures, white background
Ready to join us? Simply scan the QR code to register and become part of our medical community!
You may also submit your application documents or inquiries to:
Julius K. Quiambao Medical and Wellness Center, Inc.
Bayambang-San Carlos Rd., Brgy. Asin, Bayambang, Pangasinan 2423
Phone: 0915-889-3897
0917-166-5273
Email: credentialing_privileging@jkqmwc.com
smbdsupervisor@jkqmwc.com
Office Hours: Monday to Friday, 8:00 AM – 5:00 PM
Join us in delivering exceptional healthcare to our community.