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Ppe Form Cognizant Technology Solutions Phils. Inc

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57 views

Ppe Form Cognizant Technology Solutions Phils. Inc

Uploaded by

atattueskbd
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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COGNIZANT TECHNOLOGY SOLUTIONS PHILS., INC.

PRE-EMPLOYMENT PHYSICAL EXAMINATION SCHEDULE FORM

August 29, 2023


Date Issued:___________________ September 5, 2023
Valid Until:____________________

Name:__________________________________ Age: ___ Sex: [ ] Male [ ] Female


PRE-EMPLOYMENT PROCEDURES:

Complete Physical Examination - Mandatory Drug Test:

Complete Blood Count (CBC) - Mandatory 2 Panel v 6 Panel (KA-Kemper) v 9 Panel [ESIS]

Urinalysis - Mandatory 5 Panel (Reg) 7 Panel v 9 Panel [TMG]

Fecalysis - Mandatory 5 Panel (CVS) 8 Panel (Reg) v 9 Panel [HA]

Chest x-ray - Mandatory 6 Panel (Reg) 9 Panel [Reg] v 11 Panel (Reg)


*HR/Recruitment to tick or check the box if applicable and other DT Panels
should be identified.

Important Reminders:
• This form may be presented to Aventus Medical Care (please refer below for the address) clinic together with any 2 valid
government issued ID.

• Urine specimen containers will be provided at the clinic. Kindly collect a mid-stream urine sample during the day of examination and
immediately submit to the laboratory. (Female can submit a specimen at least 7 days after the last day of menstruation)
• The patient should collect a pea-sized stool specimen in the morning before proceeding to the clinic and must be submitted to the
Laboratory within 2 hours after collection.
• A separate urine container will be provided for the Drug Test. It is advisable to have a full bladder for the required level of urine
(60ml).

• For the Drug test, patient is required to present 2 valid IDs (company ID, driver's license, Fire arm license, GSIS ID, Integrated Bar
of the Phils., NBI Clearance, Overseas Filipino Worker's ID, Overseas Filipino Worker's Adm. ID, Passport, Police clearance, Postal
ID, PRC license, School ID, Seaman's book, Senior Citizen's ID, Solo Parent ID, SSS ID, TIN, Voter's ID) prior to any availment.

• Patient with Eye Glasses should bring it during the examination (for Visual Acuity).

• No fees will be collected from the patient. PPE costs are charged through Intellicare.

• PEME test completion should be completed within 1 month only upon PEME availment.

• Repeat examination/clearances (i.e repeat urinalysis, pulmo clearance, cardio clearance) will be shouldered by the patient.

_______________________________ Racquel C. Sison / Analiza Razote


Applicant’s signature Authorized HR Representative Signature
clinic copy
*************************************************************************************************************************************
Confirmation of Pre-employment Examination (HR copy)
(Once the above examination is complete, detach this portion and submit it to HR/Recruitment)

PPE TESTS COMPLETED: YES


WITH PENDING TEST/S: TO COME BACK ON:

Applicant’s printed name: Date: Time:


Applicant’s signature: Aventus Signature of Nurse-on-duty:
*************************************************************************************************************************************
CLINIC ADDRESS: Clinic Hours for PPE: Mon-Sat. 7am-3pm (no lunch break)
AVENTUS MAKATI CLINIC AVENTUS CLINIC-PCS AVENTUS CLINIC- STA. ROSA
6th Floor Filomena Bldg. 104 Amorsolo Street, Legaspi 2/F Philippine College of Surgeons, Edsa, 2nd Floor CARVAJAL Bldg. 2, National Highway,
Village Makati, Contact No: (02)8817‐2715, 8817‐1464 Quezon City (beside SM North Annex) (02) 8352‐4677 Balibago City, Sta. Rosa Laguna
AVENTUS ORTIGAS CLINIC AVENTUS CLINIC-U.N AVENUE Contact No:(049) 519‐4337
Unit 16, 18-20 Ground Floor AIC Grande 5th Floor, Times Plaza Building, U.N. Avenue AVENTUS CLINIC- CLARK
Tower, Sapphire road, Ortigas Center, Pasig Cor. Taft Avenue, Manila, Contact No: (02) 8353‐6807 Ground floor Tech Hub BPO Bldg. 5 SM Clark,
City, Contact No: (02) 8584‐2430 AVENTUS CLINIC-PASAY M.A. Roxas Highway,
AVENTUS CLINIC-ALABANG Scape Bldg. Macapagal Ave., cor. Pearl Drive, Brgy. Malabanias, Angeles City Pampanga
2nd Floor Sycamore ARC 1 Building, CBP, San Rafael, Brgy. 76, Pasay City Contact No: (045) 499‐8417, 499‐8419
Buencamino St., Alabang Zapote Road Contact No: (02) 8838‐0627, 8839‐0298 AVENTUS CLINIC-CEBU
Alabang, Muntinlupa City, Contact No: (02) 8556‐3598 AVENTUS CLINIC-BGC Unit 203 2/F TGU Tower I.T. Park
AVENTUS CALAMBA CLINIC Ground Floor, Unit 1 Citibank Plaza, Asiatolon, Apas, Cebu City
Ground Floor, Marchi Square, 34th St. corner Lane D, Contact No: (032) 268‐8072, (032) 268‐9236
National Highway Paciano, Rizal, Calmba, Laguna Bonifacio Global City Taguig AVENTUS CLINIC PARANAQUE
Contact No: +639661491110 Tel # (02) 8352‐8335 Unit 9 Ground Floor Aseana One Building,
AVENTUS CUBAO AVENTUS MANDALUYONG Bradco Avenue Aseana City Parañaque City
G/F Unit 17-18 Manhattan Parkview Tower One, Lower 2/F St. Francis Square Building Julia Vargas Ave., Tel #: (02) 8245 ‐ 3611; (02) 8245 – 3603
General Romulo Avenue, Barangay Socorro, corner Bank Drive Ortigas Center AVENTUS CLINIC-CEBU CYBERGATE
Araneta City Cubao, Quezon City Mandaluyong City Level 3 Unit 309 and 302 Robinsons Cybergate 2029
Contact No: 8245 0976 Tel # 7255-8974; 8542 6578 Don Gil Garcia & J. Llorente St., Capitol Site, Cebu City
AVENTUS EASTWOOD AVENTUS CLINIC- DASMARIÑAS AVENTUS CLINIC- AYALA NORTH EXCHANGE
6th Floor Unit 2A Eastwood Cyber One Bldg. Commercial Space 1-2 G/F, Antlers Square II, 3rd Floor, Retail 61 and 62, Ayala North Exchange,
Eastwood City Cyberpark Pasong Lawin, Burol, Dasmariñas City, Cavite Amorsolo Street, Ayala Avenue, Makati City.
188 E. Rodriguez Jr. Ave. Brgy. Bagumbayan, Quezon City Tel. no: (046) 894-8325 Tel No: (02) 8425-160, 8425-1624
Araneta City Cubao, Quezon City
Contact No: 02-8775-6132, 02-8475-4405
HOW TO SET UP AN APPOINTMENT FOR PRE EMPLOYMENT PHYSICAL EXAMINATION

v Patients must directly book the PEME APPOINTMENT ON AVENTUS WEBSITE


https://www.aventusmedical.net/AventusWebsite

1. Type https://aventusmedical.net/AventusWebsite/ in Address Bar on Web Browser


2. Hover the BOOK AN APPOINTMENT and click BOOK NOW

3. This will be redirected to the Appointment Portal. Choose the preferred clinic and Pre-Employment Medical Exam (PEME)

4. Then, fill up your Personal Information and other details needed. Lastly, click SUBMIT APPOINTMENT.

5. Upon submission, you will get a confirmation SMS and email (if available) of your appointment.

IMPORTANT REMINDERS
• Patients must schedule an appointment with Aventus Clinic at least 2 days prior PEME preferred date
• Wait for the confirmation of Aventus regarding your PEME schedule
• If the patient failed to visit the clinic on his/her appointment date, he/she should schedule
an appointment again in the website
• No confirmed appointment, No PEME
• Bring the following: PEME SLIP, valid IDs and face mask
• Please always include the Complete Company Name. This is required for successful booking.

• For paperless transaction, please kindly fill‐out the online forms thru the link below or using the QR code below. Kindly
accomplish this form ONLY within 24 hours prior to date of scheduled appointment.
https://www.aventusmedical.net/retail-clinic/portal

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