To make an appointment at any of our locations, please call: (808) 942-3644. Fax: (808) 955-7970
  Akamai Foot DoctorDr. Nathalie E. Sowers  
  Forms  
 
NEW PATIENT REGISTRATION FORMS
(Select Save As: when you right click
the following links with your mouse.)

      Demographic Sheet (signature required)
      Health History (signature required)
      HIPPA Policy Acknowledgement (signature required)
      HIPPA Policy (keep for your records)

MEDICAL RECORDS RELEASE FORMS

      Authorization for Use and Disclosure of Records

(Please note that a fee will be assessed for all patient-to-doctor requests.  There is no charge for doctor-to-doctor requests if delivery is not required. See form for more details.)

 
 
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