New Patient Referrals
Our goal is to see Referrals as quickly as possible – but if you have a truly urgent referral please contact the office directly to schedule at:
808-523-0445 option 3
For all other referrals Please either use the fillable form to the right or print and fax back the form with the requested items.
All new patient referrals require:
- Demographic Sheet
- Copy of Insurance Cards/ID
- Last 3 Blood Test Results
- Last 3 Progress Notes (H&P / Consult Notes)
- Imaging Studies (Ultrasound, CXR, EKG, etc…)
- Medication List
- Immunization History
- FOR HMO/QUEST/TRICARE WEST PATIENTS, PLEASE SEND REFERRAL