New patient process for patients whose last primary care provider used EPIC electronic medical record

Kapa’a Pediatrics also uses EPIC, which simplifies your child's new patient process, as we can easily view their past records after permission. If you are unsure, please call and ask your last provider. Many large centers like Wilcox, Kapiolani Medical Center, Queens, and Straub use EPIC.

  1. Complete the ‘Patient Registration Form.’ Be sure put your individualized acceptance code that was received by our staff on the form at the top.

  2. Complete the ‘Authorization to Release Protected Health Information.’ Under the “Health Information to be Released” section check the ☐Entire Health Record box, since we will be able to see the entire medical record. Although you will not need to send this form to your last provider we will need to keep a copy on file to give us permission to review the EPIC records.

You are finished! Please email, fax, or deliver the following to our office.

  • Patient Registration Form

  • Authorization to Release Protected Health Information Form

  • Insurance Card of Patient (copy of front and back)

Once received, we will contact you to schedule any future recommended appointments.