ENDODONTIC ASSOCIATES LLC-  Endodontists (Root Canal Specialists) in Honolulu and Aiea, Hawaii
HONOLULU: (808) 591-1515
AIEA: (808) 455-9051
  • HOME
  • OFFICES
    • AIEA
    • HONOLULU
  • OUR TEAM
    • DR. CRAIG HAGA
    • DR. WADE NOBUHARA
    • DR. ADAM INABA
    • DR. ANDREW INABA
  • TESTIMONIALS
    • PATIENT TESTIMONIALS
  • TREATMENTS
    • ROOT CANAL THERAPY
    • ENDODONTIC RETREATMENT
    • ENDODONTIC SURGERY
  • PATIENT INFORMATION
    • CHECK-IN INFORMATION
    • ELECTRONIC PATIENT FORMS
    • INSURANCE AND PAYMENT INFORMATION
    • FREQUENTLY ASKED QUESTIONS
  • REFERRING DOCTORS
    • ONLINE REFERRAL SYSTEM
    • REFERRAL FORM
ELECTRONIC PATIENT FORMS

Due to Covid-19, we have modified our protocols to limit person-to-person interaction. We kindly ask that you click the button below to fill out our electronic registration forms prior to your appointment. If possible please upload your drivers license/state ID and dental insurance cards at the end of the registration forms.
Click here
If you would rather manually fill out the forms, please download/print the individual forms below and bring them to your appointment.
Patient Registration Form
File Size: 44 kb
File Type: pdf
Download File

HIPAA Privacy Form
File Size: 21 kb
File Type: pdf
Download File

Consent and Insurance Release Form
File Size: 16 kb
File Type: pdf
Download File


Having trouble filling the required forms? Contact us by phone at our Honolulu or ​​Aiea office for further assistance. 
Honolulu Office
Ala Moana Shopping Center
1441 Kapiolani Boulevard, Suite 208
Honolulu, HI 96814

Phone: (808) 591-1515
Fax: (808) 593-8628 
Aiea Office
Mary Savio Medical Plaza
98-1247 Kaahumanu Street, Suite 218

Aiea, HI 96701

​Phone: (808) 455-9051

Fax: (808) 486-0344