OSPITAL NG MAKATIDepartment of Otorhinolaryngology

Head and Neck SurgerySAMPAGUITA ST. BRGY. PEMBO MAKATI CITY 1200Tel no. 882-6316 LOC 215/309

`November 5, 2014TO:PERRY ISHMAEL G. PERALTA, MD., FPCEM

Medical Director

JOSEPH G. ANICIETE

Assistant to the Medical Director for Clinical Operations

THRU:ANA CONCEPCION BILIGANPatient Safety OfficerDear Sir/Madam:

Greetings!

Our department would like to request from your good office the approval of the attached Newborn Hearing Screening Test result form to be included in our Hospital Information Management System (HIMS) which will be accessed by the audiometrist. We are hoping for your favorable response. Thank you very much. Sincerely, Khristine T. Girado, M.D.Chief Resident

Noted by:

ALBERTO F. CALDERON, M.D.

Department Chairman

Alberto F. Calderon, M.D.

Department Chairman

Howard Enriquez, M.D.

Training Officer

Consultant Staff

Francis V. Roasa, M.D.

Elmo R. Lago, Jr. M.D.

Bernardo D. Dimacali, M.D.

Joseph Ray Richard R. Cedeo, M.D.

Noel O. De Guzman Jr., M.D.

Amando Virgilio S. Santos, M.D.

Carlo A. Nofuente, M.D.

Eduardo C. Yap, M.D.

Chairman Emeritus

Resident Staff

Michael Luke T. Salinas, M.D.

Khristine T. Girado, M.D.

Roderick B. de Castro, M.D.

Benlor Y. Buendia, M.D.

Anna Victoria G. Garcia,M.D.

Charmagne Ross E. Bato, M.D.

Monique Lucia A. Jardin, M.D.

Bryan Justin C. Sandejas, M.D.