Congratulations on your growing family!

We’re excited to partner with you in caring for your new baby. Please fill out the form below so we can gather the information needed to welcome your little one into our practice.

Your Name

First Name

Last Name

Spouse's Name

First Name

Last Name

Phone #

(###)

###

####

Anticipated Insurance:

Expected Due Date

Expected Gender

Where are you planning on giving birth?

KVMH

Wilcox

Home Birth

Will your baby be receiving the Vitamin K injection? At Kapaʻa Pediatrics, we require newborns to receive the Vitamin K injection as part of our standard of care. This injection significantly reduces the risk of serious bleeding complications and has been shown to be extremely safe. If after you review the research (down below) you disagree, we will likely not be a good fit.

Is this your first child?

To learn more about Vitamin K for babies, please review this information from the CDC.