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.
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.
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 |
| HIPAA Privacy Form |
| Consent and Insurance Release Form |
Having trouble filling the required forms? Contact us by phone at our Honolulu or Aiea office for further assistance.