Uhs Form

PROCEDURES FOR PHYSICAL EXAMINATION OF INCOMING FRESHMEN
OF UP DILIMAN FOR SCHOOL YEAR 2013-2014

The Office of the University Registrar requires all incoming freshmen to secure a medical certificate from the University
Health Service (UHS) prior to enrolment. This can be obtained after undergoing a complete physical-medical
examination either at the UHS or any reputable hospital/clinic of choice. The steps to follow are:
A.
Physical-Medical Examination at the University Health Service

1. The schedule of pre-enrolment physical examination this year is until May 31, 2013, Mondays thru Fridays except
holidays, from 8:00 to 11:30 a.m. and from 1:00 to 4:30 p.m. Incoming freshmen may undergo their physical
examination at the UHS as soon as they receive their Notice of Admission into UP Diliman.
2. Present the following documents at the Public Health Unit office if before April 1, 2013 (at the UHS Conference
Room thereafter):
a. Notice of Admission
b. Consent for Physical Examination for less than 18 years old duly signed by parent or guardian. NO
CONSENT, NO EXAMINATION.
c. UPHS Form No. 2 duly accomplished with a 2 x 2 ID Photo
d. UPHS Form No. 2C
(The UPHS forms and Consent form are all enclosed with the Notice of Admission and can also be
downloaded at www.upd.edu.ph.)
e. Chest X-ray film taken outside UHS within the last 12 months and official result (reading) with 2 Xerox
copies.
(NOTE: Students may opt to have their Chest X-ray done at other reputable hospitals/facilities or
submit their recently-taken chest X-ray film and result before undergoing the physical examination
proper at the UHS.)
3. After presenting the above documents, you will be directed to any of the following areas:
a. X-ray Students who will undergo Chest X-ray at the UHS are advised to wear T-shirts without buttons or
zippers (Male or Female). The results can be claimed after two (2) working days from the X-ray Section.
b. Public Health Unit for height, weight, BP determination, and visual acuity testing.
c. Dental Unit
d. Triage (last step) for physician assignment.
4. After completing all the stages of the physical examination (3a to d above), submit the accomplished forms and
chest X-ray results to the Public Health Unit to claim your medical certificate. If the entire procedure cannot be
accomplished in one day, do not submit the unfinished forms. Keep the unfinished form until you return to
complete the rest of the pre-enrolment physical examination.
5. Submit your medical certificate to the Office of University Registrar for enrolment.
B.
Physical-Medical Examination in facilities other than the UHS

1. Go to a hospital or a diagnostic center (private or government) for a Chest X-ray.
2. Undergo your medical and dental examination and ask your attending physician and dentist to accomplish and
sign your Form 2C. They should indicate their assessment and any recommendation(s) at the bottom of the form.
The physician, for example, should write if the student is physically fit/unfit for enrolment. Forms without such
information will be considered invalid.
3. You can secure your medical certificate at the UHS Public Health Unit by presenting the following documents:
a. Notice of Admission
b. Chest X-ray film and official result with 2 Xerox copies
c. Duly accomplished UPHS Forms No. 2 and No. 2C.
4. Submit your medical certificate to the Office of University Registrar for enrolment.
Prepared by:
Dr. Hector L. Edrosa
Chairman, PE of Incoming Freshmen Committee
January 8, 2013
University Health Service

UNIVERSITY OF THE PHILIPPINES
DILIMAN, QUEZON CITY
PhilHealth
______________________, 2013
CONSENT for PHYSICAL EXAMINATION
I hereby grant consent to any of the staff physicians of the U.P. Health Service, Diliman,
Quezon City to conduct a thorough physical/medical examination of my
son/daughter/charge ____________________________________________________________ as a
pre-requisite for admission to U.P.
___________________________________________
Name in Print/Signature
Relation to Student: ________________________
Date :______________________________________

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PROCEDURES FOR PHYSICAL EXAMINATION OF INCOMING FRESHMEN

OF UP DILIMAN FOR SCHOOL YEAR 2013-2014

Physical-Medical Examination at the University Health Service

Physical-Medical Examination in facilities other than the UHS

University Health Service

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