New Patient Forms

Please download both of the above forms and email completed forms to at least 48 hours prior to appointment or please print and bring the completed forms to your appointment.

(*signature may be required in person)

Medical Records Release

Please complete the appropriate form (with signature) and email to or mail to the following address.

Retina Consultants of Hawaii

Attn: Kelli-Ann Lum

98-1079 Moanalua Road, Suite 470

Aiea, HI 96701