​   A NEW PATIENT PACKET IS REQUIRED
​Click on the links below and print both items:

​[click here] "New Patient Packet"
[click here] "Account Registration Form" ​

OPTIONS TO SUBMIT COMPLETED FORMS:
1. Place in the DROP BOX at front entry
or bring to the front desk during regular clinic hours

2. Fax to (808) 828-1666

3. Mail to: North Shore Medical Center2490 Oka Street, Kilauea, HI 96754​

If you need to request medical records from your previous provider or from our providers, please click here to print your "RELEASE OF INFORMATION FORM"
Use one the options above to submit your form. 
(We DO NOT receive forms via email)