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West Hawaii Community Health Center provides you with the opportunity to complete or view our patient forms before your appointment.  PDF forms are provided below.

West Hawaii Community Health Center is committed to protecting the privacy of our patients and complies with the Health Insurance Portability and Accountability Act (HIPAA). We encourage our patients to read their Patient Rights and Responsibilities to be well-informed and discuss their decisions with our health care team.

New Patient Forms – Medical

New Patient Packet – English

New Patient Forms – Dental

  • New Adult Dental Patient Packet – English
  • New Keiki Dental Patient Packet – English

Eligibility and Assistance Forms

For questions about Insurance Eligibility, please call (808) 327-0803.

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