Patient Only

Create Patient Account

Step 1 — Email Verification

Enter your email address. We'll send a 6-digit OTP to verify it.

Email Address *

Step 2 — Identity & Residency

Upload your Philippine National ID for digital verification, review the extracted details, and confirm Bago City residency.

National ID Verification

Upload National ID *

Upload a clear photo of the front of your Philippine National ID. We will securely read your details and auto-fill the form. Your name, date of birth, and National ID number cannot be changed after extraction—upload a new ID image if anything is wrong.

Upload your Philippine National ID

Front side only
JPG, PNG or PDF
Maximum file size: 5 MB
Ensure the image is clear and well-lit
Avoid blurry or cropped photos

Drag & drop here, or use Choose File below

Choose File

Personal Information

First Name *

Middle Name (optional)

Last Name *

Date of Birth *

Age (auto-computed)

Gender *

Civil Status *

National ID Number * (auto-filled from ID)

Address Information

Region *

Province *

City / Municipality *

Barangay *

Street / House Address

Health map location is assigned automatically from your selected barangay — no GPS pin needed.

Confirmation

I confirm that the information above matches my government-issued National ID and that all details are accurate.

Upload your National ID to auto-fill the form, complete any missing fields, confirm the details, then create your account.

Step 3 — Patient Details

Complete your account, contact, and basic medical profile. Bago City residency confirmed.

Bago City Verified

Account Security

Create a secure password for your MedConnect account.

Email Address

✓ Verified via OTP

Password *

Confirm Password *

Contact Information

How can healthcare staff reach you?

Contact Number *

Patient Complaint

Optional — You can share your symptoms now or skip this step and continue registration.

Patient Complaint Optional

If you have a patient complaint to share, describe it above. If you don't have one or don't want to provide one now, you can skip this step and continue your registration.

0/500

You can provide a patient complaint later when booking a consultation.

Basic Medical Information

These health details help healthcare providers better understand your medical history before your consultation.

Blood Type *

Do you have any known allergies?

Yes No

Are you currently taking any maintenance medications?

Yes No

Have you been diagnosed with any long-term medical conditions?

Yes No

Please accept the privacy consent to enable submission.

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For emergency cases, please proceed to the nearest healthcare facility immediately.

Step 1 — Email Verification

Step 2 — Identity & Residency

Step 3 — Patient Details

Account Security

Contact Information

Patient Complaint

Basic Medical Information

Privacy Consent