Republic of the Philippines

Department of Health
National Kidney and Transplant Institute
Department'of Pathology and Laboratory Medicine
AiltwIWM4WffiWWW

The National Reference Laboratory for Hematology

National External Quality Assessment Scheme in Hematology for the year 2019

Dear Participant,

The National Kidney and Transplant lnstitute (Nl(Tl) National Reference Laboratory (NRL) for Hematology
will be in its '12"' year of implementing the National Extemal Quality Assessment Scheme (NEQAS) in
Blood Count on 2019. This annual quality assurance program aims to help laboratories attain accurate and
reliable analytical results and achieve inter-laboratory comparability as well. By virtue of the Department of
Health (DOH) Administrative Order No. 2007-0027 dated August 22,2A07 (Revr'sed Rules and Regulations
Governing the Licensure and Registration of Clinical Laboratories in the Philippines), participation in this
scheme is one of the requirements for renewal of License to Operate (LTO) of clinical laboratories of all
categories.

As per DOH Depailment Memorandum no. 2009-00868 issued in September 8, 2014, we shall be
charging a participation fee of three thousand and five hundred pesos (Php 3.500.00) to defray costs of
reagents, supplies, and other operating expenses. Payment may be paid in cash or in check payable to
Itfa-tiofl'af Kidfleli and Transplaff lnstitute via the NKTI cashier, or through a deposit to its bank account
using the following details:

Account Name: National Kidney and Transplant lnstitute-Special Project

Account Number: Current Account # 0232-1A86-22
Bank Name: Landbank West Avenue Branch, Quezon City
(/Vofe: For payments made through bank deposit, kindly send us the oriqinal deposit slip and indicate the
BANK BRANCH where the transaction was done.)

We will be accepting registrations beginning Januarv 2. 2019 until Mav 31. 2019. PLEASE TAKE NOTE
OF THESE IMPORTANT REMINDERS AND ANNOUNCEMENTS:

1. Register as early as possible, to facilitate the public bidding process for the NEQAS samples and
hence, the timely distribution of the packages.

2. Submit to us your duly accomplished registration documents through courier mail or persoryrl detiverv
to the NRL office (Mondays to Fridays, 8:00 A.M. to 5:00 P,M.). We will not accept documents sent
through electronic mail or fax.

3. Refrain from making bank deposits beyond the registration period without prior approval of the
NRL-NKTI, as these pavments will not be credited. refunded. or carried over to the next NEQAS
cvcle.

4. The NRL-NKTI is in the process of procuring an online / web-based NEQAS information system.
Our goals are the faster (online) issuance of NEQAS reports and Certificates of Performance by 201g,
easier (online) registration by 2A20, at no extra cost to the laboratories, We would like to notify you
this early that as soon as this system becomes operational, possibly by the 4m quarter of 2019, we
will no longer send registration documents through courier. lnstead these documents will be made
available for download from the said web-based system.

For questions or concerns, you may contact Ms. Joanna M. Francisco or Mr. Noel T. Segovia through 981-
0300 local 1151 or 09985490215 or nrl.nkti.hematology@gmail.com.

Thank you.

Sincerely !ours,71 Noted by:

/*/
PAMELA n. #Ios REYEs, MD, DPsP ARNOLD J MD, FPSP
Coordinator, NRL-NKTI Chair, and Laboratory
Medicine, NKTI
 Republic of the Philippines
Department of Health
National Kidney and Transplant Institute
Deparment of Pathology and Laboratory Medicine

The National Reference Laboratory For llematology

National External Quality Assessment Scheme (NEQAS) in Hematology for the year 2019

ARTICIPANT NO.:
EW PARTICIPANT: m
of Clinical Labo ratory:

Mailing Address:
Street no. Street name Barangay

Municipality / City Zip Code Region

Landmarlds,
Tel. No.: Lab. Mobile No.: Lab. Email Add.:
Person (1):
el. No.: Mobile No.: Email Add.:
Person (2):
el. No.: Mobile No.: EmailAdd.:
fication: t$ nospitat-Based * Govemment * r"rti"ry
fJ rree-standing f* private H* seconoary
f$ otn"r, (i.e. RHU, CHo, SHC, etc.): f* prirrry
lssued on: Valid Until:

Name of Director/Chief of Hospital/Owner:

Name of Head Pathologist:

Name of Chief Med. Tech.:

Automated anua Analyzer and reagent brand name

* Hemoglobin m m
*
t3
Hematocrit m t]
RBC Count
m m
* WBC Count m m
tl Platelet Count m m
 Republic of the Philippines
Department of Health
'
National Kidney and Transplant Institute
Department of Pathology and Laboratory Medicine

The National Reference Laboratory for Hematology

National External Quality Assessment Scheme in Hematology

PAYMENT SLIP

Date:
*Participant No.:
*Name of Laboratory:
*Address:

MODE OF PAYMENT (Please CHECK appropriate box):

The amount of PHP 3,500:

B has been paid drectly to NKTI Cashier

n has been deposited to:
Account Name: NATIONAL KIDNEY AND TRANSPLANT INSTITUTE-SPECIAL PROJECT
Current Acct No. : 0232-1086-22
Branch: LANDBANK West Avenue Branch, Quezon City
Note: indicate in the original deposit slip the BANK BRANCH where transaction was done.
* is enclosed as a check(3)payable to Lhe NATIONAL KIDNEY AND TRANSPLANI INSTITUTE
Check No. Bank:

NOTE:
1. Please fill up and return this form, the Original Deposit Slip, and your filled out NRL-NKTI Hematology NEQAS Registration Forrn to the
National Reference Laboratory for Hematology, National Kidney & Transplant Institute, East Avenue, Dilirnan, Quezon City. PLEASE KEEP
COPIES FOR YOUR RECORDS.
2. The Official Receipt will be delivered together with your EQAS Sample.
3. Personal checks WILL NOT BE ACCEPTED.

><
. Republic of the Philippines
Department of Health

National Kidney and Transplant Institute

Department of Pathology and Laboratory Medicine

The National Reference Laboratory for Hematologr

National External Quality Assessment Scheme in Hematology

PAYMENT SLIP

Date:
*Participant No.:
*Name of Laboratory:
*Address:

MODE OF PAYMENT (Please CHECK appropriate box):

The amount of PHP 3,500:

n has been paid directly to NKTI Cashier

E has been deposited to:
Account Name: NATIONAL KIDNEY AND TRANSPLANT INSTITIJ'TE.SPECIAL PROJECT
Current Acct No. : t232-1086-22
Branch: LANDBANK West Avenue Branch, Quezon City
Note: indicate in the original deposit slip the BANK BRANCH where hansaction was done.
(3)
G is enclosed as a check payable to the NATIONAL KIDNEY AND TRANSPLANT INSTITITTE
Check No Bank:

NOTE:
1. Please till up and return this tbrm, the Original Deposit Stip, and your lilled out NRL-NKTI Hematology NEQAS Regisfiation Form to the
National Reference Laboratory for Hematolory, National Kidney & Transplant Institute, East Avenue, Diliman, Quezon City. PLEASE KEEP
COPIES FOR YOUR RECORDS.
2. The Official Receipt will be delivered together with your EQAS Sample
3. Personal checks WILL NOT BE ACCEPTED.