All the necessary patient information forms are available here as PDF files. Click on the links to download the files you need. You may submit the documents to us at our Honolulu office:

• Email us
• Fax: 808-735-6875
• You may also bring the completed forms with you on the day of your appointment

Cannot open the files? Download the latest version of Adobe Reader for free.

New Patient Registration Form

• New Patient Registration Form
• Cataract Evaluation Questionnaire
• COVID-19 Pre-Screening Questionnaire
• Ocular Surface Disease Index Questionnaire
• Read EyeSight Hawaii’s Privacy Practices

Contact Lens Fitting Examination

• Contact Lens Policy

Medical Release Forms

• Release Protected Medical Information (PHI) – TO EYESIGHT HAWAII 
• Release Protected Medical Information (PHI) – FROM EYESIGHT HAWAII
• ELECTRONICALLY Release Protected Medical Information (PHI) – FROM EYESIGHT HAWAII

Financing Options

• CareCredit – Up to 24 months promotional period
• Lending USA – 6 month promotional period and then goes into a fixed rate
• Alpheon Credit – Up to 24 month promotional period
  • Apply for Alpheon by Texting: Text BEST to 97788. This will send an application link right to your smart phone