Hawaiian Rehab Services

PATIENT WELCOME DOCUMENTS

Patient Form Instructions:

Please complete each of the following patient forms if you have a scheduled evaluation at our clinic. Once you complete each form you will be prompted to enter your email address. A signed copy of the form will then be emailed to you. You may print a copy of each form to bring to your scheduled appointment, or you may email the completed PDF forms to us prior to your appointment.

Please email completed forms to hrsmedrecs@hawaiianrehab.com If you have any questions, please contact our clinic at 808-329-0591

PATIENT ADMIT FORM

PATIENT MEDICAL HISTORY REPORT

PATIENT PAIN QUESTIONNAIRE

ATTENDANCE POLICY

Please bring in your completed forms or email completed forms to: hrsmedrecs@hawaiianrehab.com