Patient Forms

Patient Forms

Patient Forms

Patient Forms

Patient Forms

For your convenience, we have made our office forms available to you via our website. If you'd like to fill them out ahead of time, please click on the links down below. For your convenience, you can print out a blank Registration form or use the fillable form option. Please bring the forms in with you when your child comes in for their appointment.

​​​​​​​If any of your personal or child's information has changed and you wish to submit a new registration form or medical history form, please feel free to download the form and present it to our office staff at any time. Thanks!

none 9:00 AM - 4:45 PM 8:00 AM - 4:45 PM 8:00 AM - 4:45 PM Closed 8:00 AM - 4:45 PM 7:30 AM - 11:45 PM Closed dentist https://www.google.com/search?q=pediatric+dental+group+honolulu&ei=4fXQYrrBDo-J-Aar14WAAw&oq=Pediatric+Dental+Group+Hono&gs_lcp=Cgdnd3Mtd2l6EAEYADIFCAAQgAQyBggAEB4QFjIFCAAQhgMyBQgAEIYDMgUIABCGAzoHCAAQRxCwAzoKCAAQRxCwAxDJAzoHCAAQsAMQQzoSCC4QxwEQrwEQyAMQsAMQQxgBOhIILhDHARDRAxDIAxCwAxBDGAE6CwguEIAEEMcBEK8BOggIABAeEBYQCkoECEEYAEoECEYYAFCZB1j-DWCIFGgBcAF4AIABlgGIAcEEkgEDMC41mAEAoAEByAENwAEB2gEECAEYCA&sclient=gws-wiz#lrd=0x7c006de522730589:0xc01c52edfb4bf12e,3,,, # https://www.facebook.com/PDGHawaii/reviews/?ref=page_internal 8:00 AM - 4:45 PM 8:00 AM - 4:45 PM 8:00 AM - 4:45 PM 8:00 AM - 4:45 PM 8:00 AM - 4:45 PM Closed Closed 4180 Rice St. #105
Lihue, HI 96766 https://goo.gl/maps/L6oPC4zjzwMkEioe8 8082452131