New Patients – Patient Intake Forms

Instructions for filling out Intake forms if you have an Initial Office Visit scheduled.

If you have an Initial Allergy Assessment appointment, there is a different set of forms that you have to fill out at your appointment.

Please download the forms onto your computer/device, fill them out and save under your name.   Email them back to me at least 3-4 days prior to your appointment

I will contact you with my email address.

Thank you.



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Adult Intake Form

Pediatric 0-5 Years

Pediatric 5-12 Years

Release of Medical Records


Patient Login

Innovative Medicine Honolulu

Innovative Medicine Honolulu