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COVID-19 tools and resources: symptom checker, visitor restrictions, testing info and safety measures.

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Patient Forms

Below are some of our most frequently requested patient forms.

Forms may be turned in at your local health center site, or emailed to medical.records@westhawaiichc.org, call 808-333-3600 with any questions.

  • Adult New Patient Packet
  • Pediatric/Keiki New Patient Packet
  • Minor Power of Attorney
  • Release of Information Request (ROI)
  • Sliding Fee Scale Application
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