Request Hospital Admission (DTR)

Campus

Details

Room

Insurance

Review

Select Campus

Choose the Chong Hua Hospital campus where you will be admitted.

Cebu City Campus

Fuente Osmeña, Cebu City

Mandaue Campus

Mantawi International Drive, Mandaue City

Admission Details

Provide your preferred admission date, time, reason, and attending physician.

Admission Date *

Admission Time *

🌅

Morning

6:00 AM – 12:00 NN

🌇

Afternoon

12:00 NN – 6:00 PM

Reason for Admission *

Attending Physician *

Room Preference

Select your preferred room type. Final assignment is subject to availability.

Special Requests (Optional)

Room assignment is subject to availability. The admitting office will confirm your room within 24 hours of submission.

Insurance & Payment

Select how your hospital bill will be covered. You may update this at the admitting office.

Self-Pay

Pay personally via cash, card, or other accepted methods.

HMO / Insurance

Covered by an HMO provider or private insurance plan.

Company Account

Billed to your employer under a corporate account arrangement.

HMO / Insurance Details

HMO Provider *

HMO Card Number *

Letter of Authorization (LOA) (Optional)

Upload LOA (PDF, JPG, PNG — max 5 MB)

Company Account Details

Company Name *

Authorization Letter (Optional)

Upload Authorization Letter (PDF, JPG, PNG — max 5 MB)

Review & Submit

Please review the information below before submitting your admission request.

Campus & Admission

Campus—

Admission Date—

Admission Time—

Reason—

Attending Physician—

Room Preference

Room Type—

Special Requests—

Insurance & Payment

Payment Method—

HMO Provider—

HMO Card No.—

Company—

I confirm that the information provided is accurate and complete. I understand that the Chong Hua Hospital admitting office will contact me within 24 hours to confirm my room and admission details.

Admission Request Submitted!

Your request has been received by the Chong Hua Hospital admitting office. They will contact you within 24 hours to confirm your room and admission details.

Reference No: —

Questions? Call the Admitting Office at (032) 255-8000 (Cebu City) or (032) 233-8000 (Mandaue) during business hours.

Request Hospital Admission

Sign in to request admission

Select Campus

Admission Details

Room Preference

Insurance & Payment

Review & Submit

Campus & Admission

Room Preference

Insurance & Payment