PhilHealth Annex “F - RF/RHD”
Fill PhilHealth Annex “F - RF/RHD” online and download the official form as a PDF, ready to print. Every input is mapped to its printed box, so IDs, dates and amounts land digit by digit in the right cells, and a value the form cannot hold is refused with the reason instead of being printed wrong.
What you will need: Name of HCI, Date of Survey (mm/dd/yyyy) , Time started, Time ended, REMARKS, PhilHealth Survey Team, HCI Management Team, Agreements with HCI / Notes of PhilHealth after Pre-contracting survey.
The form is the agency's own, from philhealth.gov.ph (checked 2026-10-14): the PDF you download is that form with your values printed in its boxes.
The free clean PDF is that pack’s shortest form. A later form in the same pack needs the Starter plan (₱499) or above. Preview, check, and verify stay free. Not affiliated with BIR, SSS, PhilHealth, Pag-IBIG or any government agency.