You may download your patient registration forms below or we will be happy to send your patient information packet via:
E-mail, FAX, or postal service.
Please call us at 1-(808)-947-8900 or E-mail us at: KYasuharadds@yahoo.com to let us know how you would prefer we send your packet.
Download Patient Forms Here:
- Patient Information Sheet
- Dental/Medical History Sheet
- HIPAA Privacy Practices
- Office Policies
- HMSA Form Download only if you have HMSA
If receiving your patient packet by E-mail, please download and print all forms. Please read and fill out the necessary information and bring the forms with you to your appointment or you may fax them to 1-(808)-947-8999. If you will be using dental insurance, please be sure to bring your dental insurance card or information with you to your appointment.
If you would prefer to fill out your patient registration forms at the office, kindly arrive 15 minutes prior to your dental appointment. Thank you.
