Name:*
First Name Required
Last Name Required
Age:*
Age is Required
Gender:*
Gender is Required
Male
Female
Name of Hospital:
Name of Hospital is not valid
Cellphone Number:*
Cellphone Number is Required
Home Address::*
Home Address: is Required
Designation:*
Designation is Required
PRC Number : :*
PRC Number : is Required
PRC Expiration Date:*
PRC Expiration Date is Required
Do you belong to National Capital Region or a Regional Chapter?:*
Do you belong to National Capital Region or a Regional Chapter? is Required
National Capital Region
Regional Chapter
Kindly indicate your PSA Regional Chapter. If you belong to National Capital Region, click N/A:*
Kindly indicate your PSA Regional Chapter. If you belong to National Capital Region, click N/A is Required
N/A (NCR Members Only)
Baguio-Benguet-Mountain Province Chapter
Bicol Chapter
Bataan-Olongapo-Zambales Chapter
Bulacan Chapter
Cebu-Central Visayas Chapter
Central Luzon Chapter
Caraga Chapter
Eastern Visayas Chapter
Iloilo-Panay Chapter
Lanao Chapter
La Union Chapter
Nueva Ecija Chapter
Northeastern Luzon Chapter
Northern Mindanao Chapter
Negros Occidental Chapter
Northwestern Luzon Chapter
Pampanga Chapter
Pangasinan-North Luzon
Southern Cagayan Valley Chapter
Southern Mindanao Chapter
SOCCSKARGEN Chapter
Southern Tagalog Chapter
Tarlac Chapter
Western Mindanao Chapter
Pangasinan-North-Luzon Chapte
PMA Number:*
PMA Number is Required
Diplomate No. (If none, kindly write “N/A”):*
Diplomate No. (If none, kindly write “N/A”) is Required
Diplomate Year:*
Diplomate Year is Required
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
N/A
Are you a PSA Fellow? (FPSA):*
Are you a PSA Fellow? (FPSA) is Required
Yes
No
Birth Date:*
Birth Date is Required
Name of Spouse (If none, kindly write “N/A”):*
Name of Spouse (If none, kindly write “N/A”) is Required
Complete Name of Beneficiary #1 (Leave blank if not applicable):
Complete Name of Beneficiary #1 (Leave blank if not applicable) is not valid
Complete Name of Beneficiary #2 (Leave blank if not applicable):
Complete Name of Beneficiary #2 (Leave blank if not applicable) is not valid
Complete Name of Beneficiary #3 (Leave blank if not applicable):
Complete Name of Beneficiary #3 (Leave blank if not applicable) is not valid
Complete Name of Beneficiary #4 (Leave blank if not applicable):
Complete Name of Beneficiary #4 (Leave blank if not applicable) is not valid
Kindly indicate your status as a practicing anesthesiologist*:*
Kindly indicate your status as a practicing anesthesiologist* is Required
Active
Inactive
Retired
Delinquent
Kindly indicate your classification as a PSA Member:*
Kindly indicate your classification as a PSA Member is Required
Resident Trainee
Non-Diplomate
Diplomate (DPBA)
Fellow (FPSA)
Years Actively Practicing as an Anesthesiologist (Including Number of Years in Residency Training) (If retired, kindly indicate how many years of active practice you have had):*
Years Actively Practicing as an Anesthesiologist (Including Number of Years in Residency Training) (If retired, kindly indicate how many years of active practice you have had) is Required
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
Less than 1 year
Name of Primary Hospital Affiliation (If none, kindly write “N/A”):*
Name of Primary Hospital Affiliation (If none, kindly write “N/A”) is Required
City of Primary Hospital Affiliation (If no indicated hospital affiliation, kindly write N/A):*
City of Primary Hospital Affiliation (If no indicated hospital affiliation, kindly write N/A) is Required
Regions of Primary Hospital Affiliation (If no indicated hospital affiliation, kindly click write N/A):*
Regions of Primary Hospital Affiliation (If no indicated hospital affiliation, kindly click write N/A) is Required
N/A
Region I - Ilocos Region
Region II - Cagayan Valley
Region III - Central Luzon
Region IV - CALABARZON
MIMAROPA REGION
Region V - Bicol Region
Region VI - Western Visayas
Region VII - Central Visayas
Region VIII - Eastern Visayas
Region IX - Zamboanga Peninsula
Region X - Northern Mindanao
Region XI - Davao Region
Region XII - SOCCSKARGEN
Region XIII - Caraga
NCR - National Capital Region
CAR - Cordillera Administrative Region
BARMM - Bangsamoro Autonomous Region in Muslim Mindanao
Name of Secondary Hospital Affiliation (If none, kindly write “N/A”):*
Name of Secondary Hospital Affiliation (If none, kindly write “N/A”) is Required
City of Secondary Hospital Affiliation (If no indicated hospital affiliation, kindly write “N/A”):*
City of Secondary Hospital Affiliation (If no indicated hospital affiliation, kindly write “N/A”) is Required
Regions of Secondary Hospital Affiliation (If no indicated hospital affiliation, kindly write N/A):*
Regions of Secondary Hospital Affiliation (If no indicated hospital affiliation, kindly write N/A) is Required
N/A
Region I - Ilocos Region
Region II - Cagayan Valley
Region III - Central Luzon
Region IV - CALABARZON
MIMAROPA REGION
Region V - Bicol Region
Region VI - Western Visayas
Region VII - Central Visayas
Region VIII - Eastern Visayas
Region IX - Zamboanga Peninsula
Region XI - Davao Region
Region X - Northern Mindanao
Region XII - SOCCSKARGEN
Region XIII - Caraga
NCR - National Capital Region
CAR - Cordillera Administrative Region
BARMM - Bangsamoro Autonomous Region in Muslim Mindanao
Name of Other Hospital Affiliation (If none, kindly write “N/A”):*
Name of Other Hospital Affiliation (If none, kindly write “N/A”) is Required
City of Other Hospital Affiliation (If no indicated hospital affiliation, kindly write N/A):*
City of Other Hospital Affiliation (If no indicated hospital affiliation, kindly write N/A) is Required
Region of Other Hospital Affiliation (If no indicated hospital affiliation, kindly write N/A):*
Region of Other Hospital Affiliation (If no indicated hospital affiliation, kindly write N/A) is Required
N/A
Region I - Ilocos Region
Region II - Cagayan Valley
Region III - Central Luzon
Region IV - CALABARZON
MIMAROPA REGION
Region V - Bicol Region
Region VI - Western Visayas
Region VII - Central Visayas
Region VIII - Eastern Visayas
Region IX - Zamboanga Peninsula
Region X - Northern Mindanao
Region XII - SOCCSKARGEN
NCR - National Capital Region
CAR - Cordillera Administrative Region
BARMM - Bangsamoro Autonomous Region in Muslim Mindanao
College of Medicine Attended :*
College of Medicine Attended is Required
Year Graduated from College of Medicine:*
Year Graduated from College of Medicine is Required
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
N/A
Residency Training Hospital / Institution (If no indicated hospital affiliation, kindly write N/A:*
Residency Training Hospital / Institution (If no indicated hospital affiliation, kindly write N/A is Required
Year Graduated from Residency Training:*
Year Graduated from Residency Training is Required
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
N/A
Type of Fellowship/Subspecialty::*
Type of Fellowship/Subspecialty: is Required
N/A
Perinatal / Obstetric
Pediatric
Thoracic
Cardiovascular
Critical Care
Transplant
Regional
Ambulatory
Pain
Other
Name of Fellowship Hospital / Institution (Kindly indicate N/A if not applicable):
Name of Fellowship Hospital / Institution (Kindly indicate N/A if not applicable) is not valid
Year Graduated from Fellowship Training (Kindly indicate N/A if not applicable):
Year Graduated from Fellowship Training (Kindly indicate N/A if not applicable) is not valid
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
N/A
Email:*
Invalid Email
No val
Please fix the errors above
Pay
Free
Standard Registration – Payment
Free
₱0.00
Total
₱0.00
Login
Sign Up
Remember me
Forgot Password?
Sign in
Sign Up
Lost your password? Please enter your username or email address. You will receive a link to create a new password via email.
Email Reset Link
HOME
ABOUT US
Legacy
PAST PRESIDENTS
QUINTIN J. GOMEZ AWARDEE
MANUEL SILAO LEADERSHIP AWARDEE
PSA HYMN
OFFICERS & BOARD
SUBSPECIALTY & SIG
CHAPTER PRESIDENTS
CME ACTIVITIES
Convention
Midyear
Annual
Poster: Annual Convention 2024
Registration
Tagisan ng Talino
Poster
NCR – LUZON
VISAYAS – MINDANAO
Program
NCR – LUZON
VISAYAS – MINDANAO
Interesting Case Contest
Program
LINKS
GALLERY
Convention
2023
Midyear: Vigan City
Annual: Marriott Grand Ballroom
2024
Midyear: Iloilo City
HOME
ABOUT US
Legacy
PAST PRESIDENTS
QUINTIN J. GOMEZ AWARDEE
MANUEL SILAO LEADERSHIP AWARDEE
PSA HYMN
OFFICERS & BOARD
SUBSPECIALTY & SIG
CHAPTER PRESIDENTS
CME ACTIVITIES
Convention
Midyear
Annual
Poster: Annual Convention 2024
Registration
Tagisan ng Talino
Poster
NCR – LUZON
VISAYAS – MINDANAO
Program
NCR – LUZON
VISAYAS – MINDANAO
Interesting Case Contest
Program
LINKS
GALLERY
Convention
2023
Midyear: Vigan City
Annual: Marriott Grand Ballroom
2024
Midyear: Iloilo City