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Health Facility Geographic Form

DOH evaluation tool for health facility geographic (include in the submission of initial application)

Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: Republic of the Philippines
Department of Health
HEALTH FACILITIES AND SERVICES REGULATORY BUREAU

Health Facility Geographic Form
FACILITY NAME AND ADDRESS
1. Official Name of the Health
facility
2. Health Facility Type
(Example: Hospital)
3. Street name and number
4. Building name and number
(when applicable)
5. Official Region name
6. Official Province name
7. Official Municipality/City

8. Official Barangay name
GEOGRAPHIC COORDINATES OF THE FACILITY (FROM GOOGLE MAP) – PLEASE READ THE
INSTRUCTION ON PAGES 2 TO 3 BEFORE ANSWERING NUMBERS 9 TO 12:

9. Can the health facility be located in
Google Map? (check the option
that applies)

No, the image is not clear enough (blurry,
clouds,...)

Yes, the facility can be seen clearly

10. Scale at the moment of taking the
coordinate (maximum: 50 meters)

11. Latitude:

12. Longitude:


.
.
m

HF Geo Form
Revision:02
12/03/2014
Page 1 of 3

STEPS TO FILL-OUT THE BHFS HEALTH FACILITY
GEOGRAPHIC FORM (ALL FACILITIES) USING GOOGLE MAP
ON A DESKTOP

STEP 1of 4
Fill the Facility name and address section of the form like this:

*

* Enter “Not applicable” in case there is no building name nor number for that facility

STEP 2 of 4
Go to http://maps.google.com to open google map. Switch to the satellite view if
not already the case, then move to the area where the facility is located using the
search field.

HF Geo Form
Revision:02
12/03/2014
Page 2 of 3

STEP 3 of 4
If NO

Zoom on the
location of the
facility. Can you
see the facility
clearly (good
image, no
clouds)?

Stop the process

If YES
Continue the
process

Zoom on the
facility until the
scale bar (bottom
left
of
the
window) shows a
value equal to 50
or 20 meters and
write it down in
the form.

STEP 4 of 4
Right click on the location of the facility and select the “ What’s here?” option.
Read the coordinate from the search field or by passing over the green arrow
and write it down in the form with 5 digits after the period.

HF Geo Form
Revision:02
12/03/2014
Page 3 of 3
 
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