Quick Membership Application

Firstname


Lastname


Mobile (ex. 09228943492)


Landline (ex. 02-672-2385)


Email


Street Address (ex. 88 Shaw Blvd.)


City


Package


Packages

Individual Membership
  • PhP 1,000.00 per person per year
  • 24/7 EQR Membership valid anywhere within Lifeline's Coverage Area.
Household Membership
  • PhP 3,000.00 per household per year
  • 24/7 EQR Membership for any individual within a residential, including household helper and visitors.
  • Valid while within the residence.


Payments

Bank Deposit

Bank of the Philippine Islands
Acct Name: GIVEME UNLIMITED INC.
Curr Acct No: 0041-0317-51

Pls email copy of deposit slip to support@lifelinemembership.com

Scope

All ages covered.

No exclusions for pre-existing disease.

From initial emergency response to endorsement and take-over of receiving hospital. Complete authority and responsibility for patient's welfare assumed by Lifeline Rescue during the emergency response until patient is properly endorsed to receiving hospitals.

Free Emergency Quick Response (EQR) Service.

Fixed with/helicopter service and provincial ambulance conductins are also available upon request and for a fee.





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