Our Services

  



Availment Process for
HPDAI Card Holders




Availment Process for
NON-HPDAI Card Holders

     

Requirements for
Dental Clinic Affiliation

Basic Dental Services

  
     
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Health Partners Dental Access Inc.

Requirements for Dental Clinic Affiliation
 
  1. Letter of Intent *Download Letter of Intent
  2. Comprehensive Curriculum Vitae with picture & character references
  3. Photocopy of Professional License and PRC Certificate
  4. Photocopy of Business Licenses and Permit for partnership and Corporations
  5. Photocopy of Certificates of Training (postgraduate courses, if applicable)
  6. Pictures of Clinic Facilities, Location Map of clinic to nearest establishment (landmark)
  7. Clinic contact numbers/ email address (if any)
  8. Bank Account (for remittance of dental claims, preferably BPI)
  9. BIR Certificate of Registration (BIR Form No. 2303)
  10. Scanned Copy of the Clinic's Official Receipt
  11. Filled up Dentist information sheet. (if multiple clinics, please fill up 1 form per clinic) *Download Dentist Information Sheet
  12. List of Dental Services with Fees
  13. Signed Dental Clinic Affiliation Conditions (DCAC) : *Download Dental Clinic Affiliation Conditions
  14. Certificate of Registration with Securities and Exchange Commission for partnership and corporation
 
   

 
   

*Submit all requirements to info@healthpartnersdental.com
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