Room Reservation Form

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Room Reservation Form

Makati Medical Center respects the confidentiality of your personal data.

We are committed to handling your personal data with care, including your health information, which you will provide us, and it is your right to be informed how this hospital uses these data.

Please click here for the detailed Makati Medical Center privacy statement.

By filling out this online form and continuing to use this website, you agree to the hospital's processing of your personal information as explained in the privacy statement through link provided above.

Client Information

Last Name*

First Name*

Middle Name

Birth Date*

Gender*

Email*

Contact No.*

Provided By

Relation To Patient

Reservation Information

Room Type*

Doctor's Name

Reservation Date*

Mode of Payment*

HMO

Remarks

Document (Physician's Order, Letter of Authorization(LOA), Any valid ID of patient )*

Attach File

Add file

A MakatiMed On-Call service representative will contact you within two (2) business days upon receipt of this form to confirm your room reservation. Actual room assignment will be finalized on admission day and rates are subject to change without prior notice.

For more urgent reservations, please contact MakatiMed On-Call at +632 8888 8999.