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    Search Result Government ID ICV Document Vaccine Document Covid 19 Vaccine Certificate - First Dose Covid 19 Vaccine Certificate - Second Dose Covid 19 Vaccine Certificate - 1st Booster Dose Covid 19 Vaccine Certificate - 2nd Booster Dose PWD ID Senior Citizen ID OFW ID Seafarer ID Authorization Letter Passport Signature Update Questionnaire Print Certificate Print Vaccine Passport Edit Covid Certificate Edit Covid Booster Certificate Blood Serology for Syphilis - RPR Chest X-Ray Urinalysis Fecalysis Endorsement Letter Medical Record SA Seminar ID LDRS Affidavit Of Loss Edit Urinalysis Form Edit Fecalysis Form Edit Serology Form Edit Roentgenological Form Edit Roentgenological Report Edit Medical Record Local Form Edit Medical Record Foreign Form Edit QSIHSS Form Edit CTCS Form Edit QPSBS Form Edit COEFP Form Edit SASC Form Edit SAIR Form
    • Front Page
    • Back Page
    • Front Page
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    • Front Page
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    • Vaccine Doses
    • 1st Dose
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    • Country of Vaccination
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      • Name of Vaccination Facility
      • Vaccine Brand Name
      • Vaccination Date
      • Lot/Batch No.
    • 2nd Dose
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    • Country of Vaccination
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    • Country of Vaccination
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    • Country of Vaccination
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    • Laboratory Section
      • Date Received
      • Time Received
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    • Clinical Microscopy / Routine Urinalysis Gross Examination
      • Color
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    • Laboratory Section
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      • Color
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    • Laboratory Section
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    • Case No.
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    • Case No.
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    • Form Date
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    • I. General Data Birthplace
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    • Company / Agency
    • Date Released
    • II. Pertinent Medical History (A) Family History Family History Remarks
    • (B) Past Diseases/Illnesses/Allergies/Accidents/Operations
    • III. Physical Examination A. General Appearance / Vital Measurement
      • Height
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    • Visual Acuity
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      • Near-corrected O.S.
    • Auditory Acuity
    • Color Perception Test
    • B. System Review
    • System Review Remarks
    • IV. Laboratory Findings RPR
    • Urinalysis
    • Stool Exam
    • Stool Culture
    • Other Tests (If Needed)
    • V. Chest X-Ray Film No.
    • Date
    • Result
    • VI. Defects/Diagnosis
    • VII. Recommendation/Remarks
    • VIII. Referral/Monitoring Note
    • QMO Name.
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      • Form Date
      • Nationality / Citizenship
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    • Visa Status
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    • Medical Record Pertinent Medical History
    • Significant Physical Examination:
    • BP:
    • PR:
    • RR:
    • Temp:
    • Chest X-ray Report
    • Chest X-ray Report Others
    • Laboratory Report RPR
    • RPR Others
    • Urinalysis
    • Urinalysis Others
    • Fecalysis
    • Fecalysis Others
    • Other Examinations (Malaria Test)
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    • Other Requirements
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    • Referral Management/Update
    • QMO Name
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    • Name
    • Age
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    • Nationality
    • Date of Death
    • Immediate Cause of Death
    • Antecedent Cause of Death
    • Underlying Cause of Death
    • Place where the remains will be transported
    • QSIHSS Type
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    • CTCS Certificate Count
    • Type of Temperature of Storage
      • Specimens Name
      • Net Qty.
      • Specimens Collected Name
      • Specimens Collected Address
      • Specimens Transported Name
      • Specimens Transported Address
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    • OR No.
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    • Quarantine Permit Date
    • Protocol No.
    • Protocol Description
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    • Type of Temperature of Storage
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    • Name of Facility where Specimen shall be collected
    • CRO
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    • Form Date
    • Exporter Name
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    • Consignee
    • Destination
    • Type of FoodStuff
    • Origin
    • Weight of Sample
    • Size of Shipment(In Kilos)
    • Date of Loading
    • Requested Name
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    • Inspection, Monitoring and Evaluation Conducted
    • Rating
    • Rating Description
    • Establishment Name
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    • Sub Establishment Name
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    • Ship Vessel Type
    • Ship Certificate Name
    • Ship Certificate Description
    • Form Date
    • Director Name
    • Director Position
    • Name of Vessel
    • IMO
    • Classification of Vessel
    • GRT
    • NET
    • Date Issued
    • Place Issued
    • Expiry Date
    • Registry
    • Flag
    • Date on Inspection
    • Time on Inspection
    • Place of Inspection (Pier/Berth Wharf)
    • Vessel Application Type
    • Contact Person on Vessel (Name, Designation, Contact No)
    • Authorized Agent/Representative
    • Company Name
    • Auditor 1
    • Auditor 2
    • Auditor 3
    • Auditor 4
    • Chief Name
    • Chief Position
    • Reason for Non-Acceptance
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    Update Customer Questionnaire
      • Questions
      • Yes
      • No
      • Don't Know
      • Are you sick today?
      • Do you have allergies to medications, food, a vaccine component, or latex?
      • Have you ever had a serious reaction after receiving a vaccination?
      • Do you have a long-term health problem with heart, lung, kidney, or metabolic disease (e.g., diabetes), asthma, a blood disorder, no spleen, complement component deficiency, a cochlear implant, or a spinal fluid leak? Are you on long-term aspirin therapy?
      • Do you have cancer, leukemia, HIV/AIDS, or any other immune system problem?
      • Do you have a parent, brother, or sister with an immune system problem?
      • In the past 3 months, have you taken medications that affect your immune system, such as prednisone, other steroids, or anticancer drugs; drugs for the treatment of rheumatoid arthritis, Crohn’s disease, or psoriasis; or have you had radiation treatments?
      • Have you had a seizure or a brain or other nervous system problem?
      • During the past year, have you received a transfusion of blood or blood products, or been given immune (gamma) globulin or an antiviral drug?
      • For women: Are you pregnant or is there a chance you could become pregnant during the next month?
      • Have you received any vaccinations in the past 4 weeks?
      • Did you bring your immunization record card with you? It is important for you to have a personal record of your vaccinations. If you don’t have a personal record, ask your healthcare provider to give you one. Keep this record in a safe place and bring it with you every time you seek medical care. Make sure your healthcare provider records all your vaccinations on it.
      • Patient was informed regarding the possible side effects of non-observance of minimum interval time for vaccination. Despite the advurse, patient still wanted to proceed with the vaccination
      • Patient was informed regarding higher risk of possible side effects after vaccination. Despite the advise, patient still wanted to proceed with the vaccination.
    • Front Page
    • Back Page
        • Name
        • -
        • Print Name
        • -
        • Certificate No.
        • -
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      • First Name
      • Middle Name
      • Last Name
      • Suffix Name
    • First Dose
        • Vaccine or Prophylaxis
        • -
        • Date of Vaccination
        • QMO Name
        • -
        • QMO Print Name
        • -
        • QMO Position
        • QMO License Number
        • Brand Name
        • Manufacturer Name
        • -
        • Lot/Batch No
        • -
        • Valid Until
    • Second Dose
        • Vaccine or Prophylaxis
        • -
        • Date of Vaccination
        • QMO Name
        • -
        • QMO Print Name
        • -
        • QMO Position
        • QMO License Number
        • Brand Name
        • Manufacturer Name
        • -
        • Lot/Batch No
        • -
        • Valid Until
    • Booster Dose
        • Vaccine or Prophylaxis
        • -
        • Date of Vaccination
        • QMO Name
        • -
        • QMO Print Name
        • -
        • QMO Position
        • QMO License Number
        • Brand Name
        • Manufacturer Name
        • -
        • Lot/Batch No
        • -
        • Valid Until
    Is QMO name too long? Edit QMO Name
    • First Dose
      • QMO Name
      • QMO Position
      • QMO License No
    • Second Dose
      • QMO Name
      • QMO Position
      • QMO License No
    • Booster Dose
      • QMO Name
      • QMO Position
      • QMO License No
    • Meningococcal Dose
      • QMO Name
      • QMO Position
      • QMO License No
    • Influenza Dose
      • QMO Name
      • QMO Position
      • QMO License No
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    Privacy Policy

    Effective date: April 15, 2019

    Pisopay.com Inc ("us", "we", or "our") operates the www.pisopay.com website (the "Service").

    This page informs you of our policies regarding the collection, use, and disclosure of personal data when you use our Service and the choices you have associated with that data. Our Privacy Policy for Pisopay.com Inc is created with the help of the Free Privacy Policy Generator.

    We use your data to provide and improve the Service. By using the Service, you agree to the collection and use of information in accordance with this policy. Unless otherwise defined in this Privacy Policy, terms used in this Privacy Policy have the same meanings as in our Terms and Conditions, accessible from www.pisopay.com.ph

    Information Collection And Use

    We collect several different types of information for various purposes to provide and improve our Service to you.

    Types of Data Collected

    Personal Data

    While using our Service, we may ask you to provide us with certain personally identifiable information that can be used to contact or identify you ("Personal Data"). Personally identifiable information may include, but is not limited to:

    • • Email address
    • • First name and last name
    • • Phone number
    • • Address, State, Province, ZIP/Postal code, City
    • • Cookies and Usage Data

    Usage Data

    We may also collect information how the Service is accessed and used ("Usage Data"). This Usage Data may include information such as your computer's Internet Protocol address (e.g. IP address), browser type, browser version, the pages of our Service that you visit, the time and date of your visit, the time spent on those pages, unique device identifiers and other diagnostic data.

    Tracking & Cookies Data

    We use cookies and similar tracking technologies to track the activity on our Service and hold certain information.

    Cookies are files with small amount of data which may include an anonymous unique identifier. Cookies are sent to your browser from a website and stored on your device. Tracking technologies also used are beacons, tags, and scripts to collect and track information and to improve and analyze our Service.

    You can instruct your browser to refuse all cookies or to indicate when a cookie is being sent. However, if you do not accept cookies, you may not be able to use some portions of our Service.

    Examples of Cookies we use:

    • • Session Cookies. We use Session Cookies to operate our Service.
    • • Preference Cookies. We use Preference Cookies to remember your preferences and various settings.
    • • Security Cookies. We use Security Cookies for security purposes.

    Use of Data

    Pisopay.com Inc uses the collected data for various purposes:

    • • To provide and maintain the Service
    • • To notify you about changes to our Service
    • • To allow you to participate in interactive features of our Service when you choose to do so
    • • To provide customer care and support
    • • To provide analysis or valuable information so that we can improve the Service
    • • To monitor the usage of the Service
    • • To detect, prevent and address technical issues

    Transfer Of Data

    Your information, including Personal Data, may be transferred to — and maintained on — computers located outside of your state, province, country or other governmental jurisdiction where the data protection laws may differ than those from your jurisdiction.

    If you are located outside Philippines and choose to provide information to us, please note that we transfer the data, including Personal Data, to Philippines and process it there.

    Your consent to this Privacy Policy followed by your submission of such information represents your agreement to that transfer.

    Pisopay.com Inc will take all steps reasonably necessary to ensure that your data is treated securely and in accordance with this Privacy Policy and no transfer of your Personal Data will take place to an organization or a country unless there are adequate controls in place including the security of your data and other personal information.

    Disclosure Of Data

    Legal Requirements

    Pisopay.com Inc may disclose your Personal Data in the good faith belief that such action is necessary to:

    • • To comply with a legal obligation
    • • To protect and defend the rights or property of Pisopay.com Inc
    • • To prevent or investigate possible wrongdoing in connection with the Service
    • • To protect the personal safety of users of the Service or the public
    • • To protect against legal liability

    Security Of Data

    The security of your data is important to us, but remember that no method of transmission over the Internet, or method of electronic storage is 100% secure. While we strive to use commercially acceptable means to protect your Personal Data, we cannot guarantee its absolute security.

    Service Providers

    We may employ third party companies and individuals to facilitate our Service ("Service Providers"), to provide the Service on our behalf, to perform Service-related services or to assist us in analyzing how our Service is used.

    These third parties have access to your Personal Data only to perform these tasks on our behalf and are obligated not to disclose or use it for any other purpose.

    Links To Other Sites

    Our Service may contain links to other sites that are not operated by us. If you click on a third party link, you will be directed to that third party's site. We strongly advise you to review the Privacy Policy of every site you visit.

    We have no control over and assume no responsibility for the content, privacy policies or practices of any third party sites or services.

    Children's Privacy

    Our Service does not address anyone under the age of 18 ("Children").

    We do not knowingly collect personally identifiable information from anyone under the age of 18. If you are a parent or guardian and you are aware that your Children has provided us with Personal Data, please contact us. If we become aware that we have collected Personal Data from children without verification of parental consent, we take steps to remove that information from our servers.

    Changes To This Privacy Policy

    We may update our Privacy Policy from time to time. We will notify you of any changes by posting the new Privacy Policy on this page.

    We will let you know via email and/or a prominent notice on our Service, prior to the change becoming effective and update the "effective date" at the top of this Privacy Policy.

    You are advised to review this Privacy Policy periodically for any changes. Changes to this Privacy Policy are effective when they are posted on this page.

    Contact Us

    If you have any questions about this Privacy Policy, please contact us:

    Introduction

    Pisopay.com Standard Terms and Conditions written on this webpage shall manage your use of our website, Pisopay.com Inc is accessible at www.pisopay.com.ph

    These Terms will be applied fully and affect to your use of Pisopay.com Website. By using this Website, you agreed to accept all terms and conditions written in here. You must not use Pisopay.com website if you disagree with any of Pisopay.com’s Standard Terms and Conditions.

    Intellectual Property Rights

    Other than the content you own, under these Terms, Pisopay.com Inc own all the intellectual property rights and materials contained in this Website.

    You are granted limited license only for purposes of viewing the material contained on this Website.

    Restrictions

    You are specifically restricted from all of the following:

    • • publishing any Pisopay.com material in any other media;
    • • selling, sublicensing and/or otherwise commercializing any Website material;
    • • publicly performing and/or showing any Website material;
    • • using this Website in any way that is or may be damaging to this Website;
    • • using this Website in any way that impacts user access to this Website;
    • • using this Website contrary to applicable laws and regulations, or in any way may cause harm to the Website, or to any person or business entity;
    • • engaging in any data mining, data harvesting, data extracting or any other similar activity in relation to this Website;
    • • using this Website to engage in any advertising or marketing.

    Certain areas of this Website are restricted from being access by you and Pisopay.com Inc. may further restrict access by you to any areas of this Website, at any time, in absolute discretion. Any user ID and password you may have for this Website are confidential and you must maintain confidentiality as well.

    No warranties

    This Website is provided “as is,” with all faults, and Pisopay.com express no representations or warranties, of any kind related to this Website or the materials contained on this Website. Also, nothing contained on this Website shall be interpreted as advising you.

    Limitation of liability

    In no event shall Pisopay.com Inc., nor any of its officers, directors and employees, shall be held liable for anything arising out of or in any way connected with your use of this Website whether such liability is under contract. Pisopay.com, including its officers, directors and employees shall not be held liable for any indirect, consequential or special liability arising out of or in any way related to your use of this Website.

    Indemnification

    You hereby indemnify to the fullest extent Pisopay.com from and against any and/or all liabilities, costs, demands, causes of action, damages and expenses arising in any way related to your breach of any of the provisions of these Terms.

    Severability

    If any provision of these Terms is found to be invalid under any applicable law, such provisions shall be deleted without affecting the remaining provisions herein.

    Variation of Terms

    Pisopay.com Inc. is permitted to revise these Terms at any time as it sees fit, and by using this Website you are expected to review these Terms on a regular basis.

    Assignment

    Pisopay.com Inc. is allowed to assign, transfer, and subcontract its rights and/or obligations under these Terms without any notification. However, you are not allowed to assign, transfer, or subcontract any of your rights and/or obligations under these Terms.

    Entire Agreement

    These Terms constitute the entire agreement between Pisopay.com Inc. and you shall be limited to the proper Courts of Makati City, to the exclusion of all other courts and venues.

    Governing Law & Jurisdiction

    These Terms will be governed by and interpreted in accordance with the laws of the Philippines, and you submit to the non-exclusive jurisdiction of the state and federal courts located in Country for the resolution of any disputes.

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