NEW PATIENTS AND ACCEPTED INSURANCE
2024
We invite you to download any of our form(s) below so you can print them and fill them out at home before coming in for your appointment.
We accept most medical insurances, HMSA, Aetna, Blue Cross, Cigna, HMAA, HMA, Hawaii Laborers, MDX, Pacific Administrators UHA, UHC, and Akamai Advantage.
The Adult form will need to be filled out by the patient. The Child form will need to be filled out by the parent or guardian.
Current Medication List should be updated when you have any change to any medicine.
Please print out and update the Yearly Review of Systems. If you are not sure that you have updated this, please print it out, fill it out and bring it with you to your next appointment.
Please call if you have questions, please call us and talk to one of the Staff. Phone: (808) 488-3000
ADULT PATIENT REGISTRATION FORM
PDF DOCUMENT
The 2024 Adult form will need to be filled out by the patient.
This is a PDF document. Please download it, print it, fill it out and bring it with you to your next appointment. This form is not fillable, you must print it out and then fill it out.
Please use the Adult Form Button below to download the Form.
CHILD PATIENT REGISTRATION FORM
PDF DOCUMENT
The 2024 Child form will need to be filled out by the patient or parent.
This is a PDF document. Please download it, print it, fill it out and bring it with you to your next appointment. This form is not fillable, you must print it out and then fill it out.
Please use the Child Form Button below to download the Form.
ANNUAL REVIEW OF SYSTEMS FORM
PDF DOCUMENT
The Review of Systems form will need to be filled out by the patient.
This is a PDF document. Please download it, print it, fill it out and bring it with you to your next appointment. This form is not fillable, you must print it out and then fill it out.
Please use the Review of Systems Button below to download the Form.
CURRENT MEDICATION LIST
PDF DOCUMENT
The Current Medication List form will need to be filled out by the patient.
This is a PDF document. Please download it, print it, fill it out and bring it with you to your next appointment. This form is not fillable, you must print it out and then fill it out.
Please use the Current Medication Form Button below to download the Form.
