Download Intake Forms

Please download, print, and complete the intake forms below.  Bring the completed forms with you to your first visit.  We're looking forward to seeing you at your Consultation & Examination! 

Intake Form Page #1
Intake form1.pdf
Adobe Acrobat document [629.5 KB]
Intake Form Page #2
Intake form 2.pdf
Adobe Acrobat document [268.3 KB]
Intake Form #3
Intake form 3.pdf
Adobe Acrobat document [56.3 KB]

If you have trouble downloading the intake forms, please call our office at #(808) 948-8722.


Or, try clicking on the Word documents below.

Intake Form #1
Intake form 1.docx
Microsoft Word document [29.2 KB]
Intake Form #2
Intake form 2.docx
Microsoft Word document [1.2 MB]
Intake Form #3
Intake form 3.docx
Microsoft Word document [13.7 KB]

    CONTACT US AT       #(808) 948-8722


Moiliili Professional Bld.


2525 South King St., 

Suite 304

Honolulu, HI 96826


(3rd floor of

"Down to Earth"

Natural Food Store)




Monday, Wednesday, Friday:

8 am - 12 pm; 1 pm - 4:30 pm


Tuesday, Thursday, Saturday:

8 am - 12 pm


Sunday Closed