COVID UPDATE: Pearl City Medical Associates remains open and providing patient care, whether in-person or via telemedicine. We are committed to keeping our patients and community safe and healthy by staying up-to-date on current CDC guidelines.

98-1079 Moanalua Road, Suite 500 & 555

Aiea, HI 96701

Adult:          808-488-0990

Pediatrics:  808-488-1943

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Pearl City Medical Associates

Adult & Pediatric Medicine

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    Forms

    Adult Medicine

    • Patient Registration Form 

    • Adult Medicine General Patient Form

    • Request for Access to Health Information

    • Authorization for Release of Health Information from PCMA

    • Authorization for Release of Health information to PCMA

    • Authorization for Release of Records for Worker's Compensation, Auto Accident, 3rd Party Liability

    • Disability: WC-2 Physician's Report

    Pediatric Medicine

    • Patient Registration Form 

    • Child General Patient Form 

    • Request for Access to Health Information

    • Authorization for Release of Health Information from PCMA

    • Authorization for Release of Health Information To PCMA

    • Authorization for Treatment of Unaccompanied Minor

    • Children w/ Special Health Care Needs Screener

    Pearl City Medical Associates

    98-1079 Moanalua Road, Suite 500 & 555, Aiea, HI 96701

    Adult: 808-488-0990 | Pediatrics: 808-488-1943 | Business Office: 808-488-7999