The document contains two sample authorization letters for PhilHealth. Below is a sample letter for this purpose.This authorization will be in effect on the date signed and will remain in effect until your HHSA services are completed, unless you complete the below:. Authorization Letter from the member (original) and 2 Valid signature and photo bearing. I, Princess Natalie Rubianes, am writing this letter to authorize Maria Teresa Castañeda to act on my behalf regarding my PhilHealth-related transactions. Other Rights: I understand that authorizing the disclosure of this health information is voluntary. I can refuse to sign this authorization. My behalf regarding my PhilHealth-related transactions. Maria Teresa Castañeda is my mother,. LF Magpapagawa ng Resume, Resignation letter, Application letter,Authorization letter, or other letter, .