Student Medical Services Forms
Please mail, fax or File Drop (Recipient email: uhhsms@hawaii.edu) Please do not email the form to us, for security reasons.
- Telehealth Informed Consent (PDF )
- Vaccinations Pharmacy List
- Consent for Release of Medical Information (PDF ) (use the page 1 when requesting UH Hilo SMS to send your records elsewhere and page 2 when requesting records to be sent to UH Hilo SMS)
- Consent for Treatment of Minors (PDF ) (for patients under the age of 18)
- New Patient Packet (PDF )(Please fill out the New Patient Packet and send it back via filedrop or fax 808-932-7368 or you can also hand deliver to our office before your appointment)
- Requirements for Retrieving Immunization Records from HISIS (PDF )
These forms are also available at the
Obtaining Immunization Records via HiSIS
The HiSIS Public Portal is an online portal that offers a free and secure way for individuals, parents, and legal guardians to access/print/download official immunization records. This official record can serve as proof of immunization for school to submit to MedProctor, daycare, work, or travel purposes. To complete a HiSIS Immunization Record Request, the individual’s First Name, Last Name, Date of Birth, Gender, and Mobile Phone or Email Address entered must match what is listed on the patient’s HiSIS profile.