Make an Appointment

Kalihi-Palama Health Center operates on a Sliding-Scale Fee basis. This means that all services will be provided at a fee rate determined by your personal family income. All prices for services are subject to change based on your personal family income level. To be eligible for our sliding scale, we request all patients bring in a form of proof of income. This must be renewed on a regular basis.

We accept most insurance programs.

Patient Registration

Please arrive 30 minutes early for your first appointment to allow time to complete all patient registration information.

To get ahead start, you may download and print the registration form below. Be sure to have the form signed and dated, and bring the form to your appointment.

Registration Form

What to bring to your first appointment?

  1. Any printed registration forms
  2. Health Insurance Card
  3. Identification
    • US Passport
    • Driver’s License
    • Permanent Resident Card
    • State Identification Card
  4. Legal Guardianship Papers
  5. Proof of Income for Sliding-Scale Price Application which can include:
    • Pay Stub (Calculate Average per Month)
    • Determination Letter from Department of Human Services (Medicaid Recipient)
    • Social Security Benefit Letter
    • Unemployment Insurance Pay Stub
    • Current Tax Return
    • Disability Award Letter
  6. Shot Records/ Other Health Records
  7. To get WIC you need to bring:
    • Proof of income such as pay stubs, tax return or medical benefit papers
    • Proof of identity such as a state ID card or birth certificate for you and each child
    • Proof of Hawaii address such as a utility bill or rent receipt. All children you want to receive WIC
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If you are pregnant, please bring a note from your doctor that certifies you are pregnant.

If you just gave birth, please bring your baby and papers from the hospital with you. 

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