Schedule an Appointment

Use this form to request an appointment for insurance assistance, home health care, or diagnostics. Health Connect will route your request to the appropriate team or partner provider and contact you with the next steps.

Your Information

Full Name *

Full Name is required.

Email Address *

Email Address is required.

Mobile Number

Appointment Details

Service *

Please select a service.

Preferred Provider / Company

Service Type / Category

Preferred Date

Preferred Time

Additional Notes / Details (optional)

By submitting this form, you agree that Health Connect may share your information with partner providers for the purpose of arranging your appointment and contacting you regarding your request.

What happens after you submit?

Your request is sent securely to Health Connect.
We route it to the appropriate partner clinic, diagnostic center, or insurer.
You may receive a call, SMS, or email to confirm details and available schedule.

Tips for smoother processing

Use an active email and mobile number.
If you have a doctor’s request form, mention it in the notes.
Include your preferred location or city (e.g., Muntinlupa, Makati, Quezon City).