To apply as a member of the Philippine Heart Association, please print and fill up the application form below, and then send to PHA via fax or email. Fax no.: (02) 6877797. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it..

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PHILIPPINE HEART ASSOCIATION, INC.

PHILIPPINE COLLEGE OF CARDIOLOGY

 
Suite 1108, 11th Flr. East Tower, PSE Centre, Exchange Road
Ortigas Center, Pasig City, Philippines 
 
 

Tel. # (02) 4705525, (02) 4705528 / Fax # (02) 6877797

 

 


Date:
____________________

 

 

 

NOTE: Please TYPE or PRINT legibly all information. Provide extra sheet if necessary. Please fill all blanks.

Where information is not available, place “none” or “not applicable”. Incomplete or illegible forms will be returned.

 

 

 

GENERAL DATE:

 

 

 

 

 

NAME: Last

First

  M.I.

BIRTHDATE:

_________________________________

_____________________

  _____

_______________

 

 

 

ADDRESS:

 

 

Residence:

Principal Office:

____________________________________

____________________________________

____________________________________

____________________________________

____________________________________

____________________________________

Phone: ________________________

Phone: ________________________

 

 

Place asterisk (*) before address preferred for correspondence concerning this application.

 

 

HOSPITAL AFFLIATIONS:

ADDRESS:

1. __________________________________

____________________________________

2. __________________________________

____________________________________

3. __________________________________

____________________________________

 

 

MEDICAL EDUCATION:

 

 

Medical School: ______________________________

Date Graduated: ________________

Internship:  _________________________________

Date Graduated: ________________

Residency: _________________________________

Date Graduated: ________________

 

 

PAST PROFESSIONAL POSITIONS: (As trainee; faculty; hospital or government medical appointee. Exclude professional organizations)

Institution

Position

Dates

___________________________

_______________________

_____________________

___________________________

_______________________

________________________

___________________________

_______________________

________________________

___________________________

_______________________

_____________________

 

 

 

If not in practice now (e.g., still in training), or in practice but intending to relocate, state intended place of practice, if locating or relocating before this coming December 15)

 

 

 

City/ Town/ Province: _____________________________________________________________

 

PROFESSIONAL POSITIONS: (As trainee; faculty; hospital or government medical appointee)

Institution:;

Position

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

_______________________________________

 

 

SCIENTIFIC CONTRIBUTIONS: (Publications, discoveries, inventions. If publication, use bibliographic style of the Philippine Journal of Cardiology)

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

 

PROFESSIONAL PRACTICE HISTORY:(State type of practice, for examples: Family Medicine, Internal Medicine, Pediatric Cardiology, Adult Cardiology, etc.)

 

Dates:

_________________________________________________

____________________________

_________________________________________________

____________________________

_________________________________________________

____________________________

_________________________________________________

____________________________

 

 

Do you do the following? Please check:

[ ] Electrocardiography

[ ] Echocardiography

[ ] Vectorcardiography

[ ] Cardiac Catheterization

[ ] Cardiac Flouroscopy

[ ] Angiography

[ ] Exercise Stress Testing

[ ] Ambulatory ECG Monitoring

[ ] Other Special Procedures: ______________________________________________________

 

 

PROFESSIONAL ORGANIZATIONS:

Position or Membership Category:

_______________________________________

______________________________________

_______________________________________

______________________________________

_______________________________________

______________________________________

 

AWARDS/HONORS:

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

 

MEMBERSHIP CATEGORY APPLIED FOR: (Please check one.)

[ ] Fellow

[ ] Associate Fellow

[ ] Associate

 

This is a

[ ] first application

 

[ ] application for advancement from (state membership category) ___________________

 

SPONSORS: (Two (2) Fellow of the College):

NAME:

1. ____________________________________________

 

2. ____________________________________________
 

NOTE: Letters of recommendation from two (2) Fellows of the College is required.

 

I hereby certify that the information contained in this application form is true and correct to the best of my knowledge and

that I am conversant with the “INFORMATION FOR CANDIDATES FOR MEMBERSHIP OR ADVANCEMENT

(Revised, November 24, 1989) issued by the Philippine Heart Association
 

 

Applicant Signature:

 


_________________________________

 

NOTE: Please submit this application to the MEMBERSHIP COMMITTEE, c/o The Secretariat,

Philippine Heart Association, Suite 1108, 11th Flr. East Tower, PSE Centre, Exchange Road,
Ortigas Center, Pasig City, Philippines, or if applying through a Chapter,

submit to the appropriate committee of the CHAPTER, with copies of supporting documents of training, board certification(s),

publication(s), etc. Sponsorship letters shall be sent under separate cover by sponsoring Fellows.

 

Applicant: Please do not write below this line.

__________________________________________________________________________________

 

FOR APPLICATIONS COURSED THROUGH A CHAPTER:

 

Chapter Name: _____________________________________________________________________

Chapter Remarks and Recommendations: ________________________________________________

_________________________________________________________________________________

 
Chapter President:


 ____________________________________________

 

 

Signature over Printed Name

 

Application form, together with all supporting documents, shall be forwarded to the PHA Membership Committee not later

than December 15 following the filing of this application.

___________________________________________________________________________________

FOR PHA MEMBERSHIP COMMITTEE USE ONLY:

Committee Action:

_____________________________________________________________________________________

_______________________________________________________________________________________

 

Cates F. Moradoo

10/ 13/ 2005

 

 

 

 

 

 

 

PHA STANDING COMMITTEES 2014-2015

46TH ANNUAL CONVENTION
Chair          Raul L. Lapitan, MD
Members    Jorge A. Sison, MD
                  Scientific
                  Helen Ong-Garcia, MD
                  Sessions Coordinator
                  Alex T. Junia, MD
                  Registration
                  Nanette R. Rey, MD
                  Socials
                  Aurelia G. Leus, MD
                  Exhibits & Physical Arrangements
                  Eugenio B. Reyes, MD
                  Protocol
                  Romeo B. Cruz
                  Finance
                  Frederick M. Alegre
                  Lay Participation
                  Marcellus Francis L. Ramirez, MD
                  Daily Newsbeats
                  Timothy C. Dy, MD
                  Website
                  Pedro P. San Diego Jr. MD
                  Information Technology

ADVOCACY
Chair          Helen Ong-Garcia, MD               
Co-Chair     Frederick M. Alegre (Media Partners)
                  Aurelia G. Leus, MD (Lay and Paramedical Arm)
Member      Jose Jonas D. Del Rosario, MD

AWARDS
Chair         Saturnino P. Javier, MD

BUDGET
Chair         Jorge A. Sison, MD
Member     Mr. Romeo B. Cruz

BY-LAWS
Chair         Mariano B. Lopez, MD

CONTINUING EDUCATION PROGRAM
Chair         Helen Ong-Garcia, MD
Co-Chair   Nannette R. Rey, MD

CEP SUB-COMMITTEE ON CARDIOLOGY TRAINING
Chair         Nannette R. Rey, MD
Members   Chief Fellows

AUF                             Gil Alfonso, MD
CSMC                          Pierre Albert Alora, MD
CGH                            Michael Cabalatungan, MD
Chong Hua – Cebu        Makalutang Kadatuan, MD
JRMMC                        Maria Donabel Mamerto, MD
MMC                            Michelle Maliwat, MD
MDH                            April Ann Bermudez, MD
Mary Mediatrix              Nel Acorda, MD
PSH – Cebu                  Kathy Lou Tomandao, MD
PGH                             Cristine Santelices, MD
PGH Pedia                    Bee Jane T. Martinez, MD
PHC                             Paolo Villanueva, MD
PHC Pedia                    Bernadette Valdez, MD
SLMC                           Don Bailon, MD
SLMC – BGC                Loudon Antonio, MD
TMC                             Elizabeth Enriquez, MD
UPHDMC                      Jo Cris Gutierrez, MD
UST                              Lauren Valera, MD

COUNCILS AND CHAPTERS
Chair          Alex T. Junia, MD
Members:  Council Chairs and Chapter Presidents

2014-2017
Councils    Eduardo L. Tin-Hay, MD
                 Cardiac Catheterizations & Interventions
                 Erdie C. Fadriguilan, MD
                 Cardiac Pacing & Electrophysiology
                 Carlos Ponciano R. Esguerra, MD
                 Cardiac Rehabilitation           
                 Gary A. Lopez, MD
                 Cardiomyopathy & Cor Pulmonale
                 Francis M. Lavapie, MD
                 Cardiopulmonary Resuscitation
                 Jude Erric L. Cinco, MD
                 Carina B. Dipasupil, MD (co-chair)
                 Cardiovascular Anesthesia & Critical Care
                 Robin Flores, MD
                 Cardiovascular Surgery
                 Edward-Bengie Magsombol, MD
                 Cardiovascular Imaging
                 Maria Ronella T. Francisco, MD
                 Corazon A. Estevanez, MD (co-chair)
                 Martha Socorro M. Santiago, MD (co-chair)
                 Congenital Heart Disease
                 Paul Ferdinand M. Reganit, MD
                 Congestive Heart Failure       
                 Imelda Caole-Ang, MD – CAD Registry
                 Victor L. Lazaro, MD – CAD Guidelines
                 Coronary Artery Disease
                 Ronaldo E. Cuyco, MD
                 Echocardiography
                 Federick C. Cheng, MD
                 Hypertension
                 Adriel E. Guerrero, MD
                 Preventive Cardiology           
                 Jhuliet J. Balderas, MD
                 Rheumatic Fever-Rheumatic Heart Disease
                 Lilibeth M. Maravilla, MD
                 Stroke & Peripheral Vascular Disease
                 Adelaida Iboleon-Dy, MD
                 Aileen Cynthia F. De Lara, MD (co-chair)
                 Women’s Health

Chapters   Stella Marie P. Mabanag, MD
                 Northern Luzon
                 Enrico Amadeo P. Constantino, MD
                 Cagayan Valley
                 Gil Francis S. Pelagio, MD
                 Central Luzon
                 David Raymund K. Salvador, MD
                 Southern Tagalog
                 Narciso Thad S. Ciocson, MD
                 Bicol
                 Carolyn K. Fermin, MD
                 Cebu 
                 Felibert O. Dianco, MD
                 Western Visayas-Panay
                 Francisco G. Maleza, Jr., MD
                 Western Visayas-Negros Occidental
                 Richard Myles T, Montesclaros, MD
                 Northwestern Mindanao
                 Elfred M. Batalla, MD
                 Davao-Southern Mindanao
                 Walid A. Amil, MD
                 Zamboanga Peninsula

ELECTIONS AND NOMINATIONS
Chair         Eugenio B. Reyes, MD
Members   Saturnino P. Javier, MD
                 Isabelo V. Ongtengco, MD

ETHICS
Chair         Norbert Lingling D. Uy, MD

EXTERNAL AFFAIRS & LAY AWARENESS
Chair         Mr. Frederick M. Alegre

FINANCE
Chair          Mr. Romeo B. Cruz
Members    Jorge A. Sison, MD
                  Rody G. Sy, MD
                  Cesar S. Recto II, MD

LEGISLATIVE AFFAIRS
Chair         ,MD

HEART HOUSE
Chair         Joel M. Abanilla, MD
                 Rafael R. Castillo, MD
                 Antonio S. Sibulo, MD
                 Noe A. Babilonia, MD

HEART MONTH
Chair         Alex T. Junia, MD
Co-Chair    Helen Ong-Garcia, MD

MEMBERSHIP
Chair         Joel M. Abanilla, MD
Members   Eugene B. Reyes, MD
                  Saturnino P. Javier, MD

PUBLICATIONS
Chair         Raul L. Lapitan

Philippine Journal of Cardiology
Editor-in-Chief     Saturnino P. Javier, MD

PHA NewsBriefs
Editor-n-Chief         Marcellus Francis L. Ramirez, MD
Associate Editors   Don Robespierre Reyes, MD
                             Maria Lourdes Bunyi, MD

Website
Chair          Timothy C. Dy, MD
Co-Chair     Marcellus Francis L. Ramirez, MD
Member      Peter P. San Diego, MD (IT Consultant)

RESEARCH
Chair         Alisa P. Bernan, MD (2013-2016)
Members   Marie T. Magno, MD
                 Imelda Caole-Ang, MD
                 Noemi S. Pestano, MD
                 Florante D. Timbreza, MD
                 Aileen Cynthia F. De lara, MD
                 Leahdette O. Padua, MD
                 Elmer Jasper B. Llanes, MD
                 Melissa Jasmin B. Bernardo, MD
                 Joel A. Dela Rosa, MD
                 Elaine L. Gallardo, MD

TASK FORCE ON COMMUNITY SERVICE & SPECIAL PROJECTS
Chair         Aurelia G. Leus, MD

WORLD HEART DAY  
Chair         Raul L. Lapitan, MD
Co-chair    Helen Ong-Garcia, MD

SPECIALTY BOARD OF ADULT CARDIOLOGY
Chair                Cesar S. Recto II, MD
Members          Efren R. Vicaldo, MD
                        Ma. Belen O. Carisma, MD
                        Maria Teresa B. Abola, MD
                        Eleanor A. Lopez, MD

SPECIALTY BOARD OF PEDIATRIC CARDIOLOGY
Chair                Maria Rhodora Garcia-De Leon, MD
Members          Teofilo C. Cantre, MD
                        Olympia Q. Malanyaon, MD
                        Aurora S. Gamponia, MD
                        MD

ACC CHAPTER PHILIPPINES
Governor   Eugenio B. Reyes, MD
Advisory Council   Dante D. Morales, MD
                              Ma. Belen O. Carisma, MD
                              Maria Teresa B. Abola, MD
                              Eduardo S. Caguioa, MD

 

SPECIALTY BOARD OF ADULT CARDIOLOGY 2011 - 2012
Chairman: Romeo J. Santos, MD
Members:

Norbert Lingling D. Uy, MD

Mariano B. Lopez, MD
Cesar S. Recto II, MD
Efren R. Vicaldo, MD
SPECIALTY BOARD OF PEDIATRIC CARDIOLOGY 2010 – 2011
Chairman: Asuncion A. Reloza, MD
Members:
Edgardo E. Ortiz, MD
Wilberto L. Lopez, MD
Della G. Pelaez, MD
Ma. Rhodora G. de Leon, MD

PHILIPPINE HEART ASSOCIATION

PHILIPPINE COLLEGE OF CARDIOLOGY

Mission
Ensuring compassionate and quality cardiovascular care.

Vision 2021
The Philippine Heart Association shall be an Asia Pacific leader in cardiovascular care by 2021.

Broad Objectives
1. Ensure accessible, affordable and quality cardiovascular education and care for everyone.
2. Be recognized as a leading organization of cardiovascular specialties in Asia Pacific in the prevention and management of cardiovascular diseases.
3. Develop a proactive organization effectively servicing needs of its specialists, lay members and other stakeholders.

 

Annual Strategic Planning: The PHA Road Map
July 30, 2016
Bellevue Hotel, Alabang, Muntinlupa City

STRAT 2016 PIX 2

RAUL L. LAPITAN, MD
President
Chair, Membership Committee
Chair, Heart House Committee

 

JORGE A. SISON, MD
Vice President
Chair of Committee on Councils and Chapters
Chair of Heart Month 2016 Celebration

 

 

ROMEO B. CRUZ
Vice President for Finance
Chair, Finance Committee
Co-Chair, Budget Committee

 

FREDERICK M. ALEGRE
Vice President for External Affairs
Chair, Committee on External Affairs

 

2014 rey

NANNETTE R. REY, MD
Secretary
Over-all Chair, PHA 48th Annual Convention
Chair, World Heart Day 2016 Celebration

 

2014 leus

AURELIA G. LEUS, MD
Treasurer
Chair, Scientific Committee for the 48th Annual Convention 
Director in-charge, Research Committee

 

bugarin1

ORLANDO R. BUGARIN, MD
Director
Chair, Continuing Education Program Committee
Chair, Advocacy Committee

 


vilela

GILBERT C. VILELA, MD
Director
Chair, Sub Committeee on Continuing Education Program 

Cinco Jude Erric

JUDE ERRIC L. CINCO, MD
Director
Co-Chair, Advocacy Committee 
Liaison Officer for Medical Societies

 

Alex T. Junia, MD
Immediate Past President
Chair, Nominations and Elections Committee

 

Advocacy

World Heart Day

Camp BraveHeart

Healthy Lifestyle Campaign

Heart Fair

Contact Us

Call Us: +63 2 470-5525, 470-5528
              +63 2 687-7797

Email Us: This email address is being protected from spambots. You need JavaScript enabled to view it.

Website: http://www.philheart.org

Suite 1108, 11th Flr. East Tower, PSE Centre, Exchange Road Ortigas Center, Pasig City, Philippines

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