Documentary Requirements
Eligible Government health facilities shall submit the following documentary requirements:
- Letter request addressed to the General Manager
- *In the case of PCSO-initiated donations, the requirement for such letter request shall be dispensed with.
- Project Proposal containing the following data and materials:
- Rationale/Justification;
- Objectives;
- Photo of the health facility and area where the medical equipment is intended to be installed;
- Cost Benefit Analysis to include the following: (Refer to the attached CBA format)
- d.1. Cost/Expense per procedure/patient; and
- d.2. Estimated number of patients to be provided services with such equipment.
- Profile of the Medical Facility to include the following:
- Vision/Mission statement;
- List of Key Officials;
- Area of Service Coverage;
- Existing Programs and Services Offered;
- Authorized Bed Capacity/Occupancy Rate, if applicable;
- Case Mix;
- Manpower Complement required to use/operate the equipment with proof of expertise (license) of the technical personnel;
- Statistical report for the past three (3) years.
- License to Operate of the medical facility issued by the Department of Health (DOH).
- Maintenance and Other Operating Expenses (MOOE)-Commitment of the hospital to fund the maintenance expenses to sustain the operations and functionality of the equipment, including the purchase of reagents, supplies, and other consumables and the provision of an appropriate area for the equipment to be functional.