Online Registration for US Visa Applicants
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Increase in Medical Examination Fees Effective October 1, 2017


Effective October 1, 2017, St. Luke's Medical Center Extension Clinic (SLEC), the Embassy's accredited panel physician, will begin charging a new medical examination fee:

17,025.00 PHP for adult immigrant visa applicants ages 15 and above
and
9,583.00 PHP for children ages 14 and below.

This medical fee increase is based on U.S. Public Health Services and the Centers for Disease Control (USPHS/CDC) guidelines and technical instructions to replace Tuberculin Skin Tests (TST) with Interferon Gamma Release Assay (IGRA), a new and more reliable type of blood exam used to detect tuberculosis infection (TB).









St. Luke's Medical Center Extension Clinic logo

ONLINE REGISTRATION

(For U.S. Immigrant Visa Applicants Only)


Upon arrival at SLEC, applicants WILL BE ACCOMMODATED ON A FIRST-COME, FIRST-SERVED BASIS. NO APPOINTMENT IS NECESSARY. This online registration form aims to reduce registration time by having most of the applicant's information ready upon arrival at the registration area. Pre-registered applicants should only need to have their biometrics captured upon arrival at the reception area.

INSTRUCTIONS:

  1. COMPLETE ALL FIELDS. KNOW ALL DETAILS OF YOUR APPLICATION BEFORE ACCOMPLISHING THE ONLINE REGISTRATION FORM.

  2. FOR FAMILIES, AN ONLINE REGISTRATION MUST BE SUBMITTED FOR EACH FAMILY MEMBER. FAMILIES WITH INCOMPLETE ONLINE APPLICATIONS WILL NOT BE ACCOMMODATED AT THE RECEPTION AREA.


  3. PLEASE TYPE YOUR COMPLETE ADDRESS. DO NOT ABBREVIATE ANY DETAILS PERTAINING TO THE STREET, CITY, OR STATE.


  4. Once all fields have been filled out, Click on the 'Preview' button. The next step will display a preview of all data entered.
  5. Review data for errors. Use the form to correct them as needed, click 'Preview', to preview data to be submitted.
  6. If all data are correct, click on the 'Register' button to submit your registration.

    7. ALL APPLICANTS WILL BE SERVED ON A FIRST-COME, FIRST-SERVED BASIS. NO APPOINTMENT IS NECESSARY.

PLEASE COMPLETE REGISTRATION BEFORE PRINTING THIS PAGE.
Your registration has NOT been submitted. This printout will not be honored when presented at SLEC. Refer to the instructions found at the beginning of the registration form to complete your registration.

NOTE: ONLINE REGISTRATION SUBMISSIONS ARE ONLY VALID FOR ONE MONTH. PLEASE REGISTER NO EARLIER THAN ONE MONTH BEFORE YOUR INTENDED DATE OF MEDICAL EXAM.

CASE INFORMATION

NVC Case Number* Confirm NVC Case Number*
Visa Preference Category*
Priority Date
Interview Date
Interview Source

APPLICANT DETAILS

Basic Information (as indicated in passport)

Name (Last Name, First Name, Middle Name)*
Date of Birth*
Gender*
Civil Status*
Birthplace *
 

Contact Information

FOR APPLICANTS CURRENTLY LIVING IN THE PHILIPPINES:

PHILIPPINE ADDRESS
 
 
 
 


FOR APPLICANTS CURRENTLY LIVING OUTSIDE THE PHILIPPINES:

OVERSEAS ADDRESS

Country*
 
 
 
 



Contact Number(s), separate with a slash*
Email Address*

Note: We are currently having issues sending confirmation emails to Hotmail/Live/MSN/Outlook.com email addresses. Please try a different email address.

Present Country of Residence*
Prior Country of Residence*

Passport Information

NOTE: Passport must be more than 6 months valid.
Passport Number*
Issued by (Country)*
Issue Date*
Expiration Date*

Additional Questions

Have you been issued a U.S. Tourist Visa?* No                    Yes
Issuance Date
Expiration Date


Highest Educational Attainment*
 
Occupation*
Previous Medical Examination at SLEC
Date of Previous Chest X-ray

PETITIONER'S INFORMATION

Name of Petitioner*
Is the Petitioner still alive?* Yes No
U.S. Address*

Relationship*



Contact Number*
Email Address*
U.S. Contact Person*
Contact Number*
Nearest Relative in the U.S.*
Relationship*
U.S. Address*
U.S. Contact Number*
Intended Port of Entry*
Estimated Date of Departure for the U.S.*