New Patients – Forms

There are 2 ways to complete the forms:

1. Print the PDF document, fill it out in pen, and drop it off at the clinic (or scan and email it)

2. Save the Intake Form and fill it out on your computer. Save, and then email it to us.

Adult Intake Form

Pediatric 0-5 Years

Pediatric 5-12 Years

Release of Medical Records

Online Version Not Available


Patient Login

Innovative Medicine Honolulu

Innovative Medicine Honolulu