New Patient Forms

Prior to your first appointment, please download, print, and fill out the the following forms. Please bring forms with a picture ID and all insurance cards.​ Please give 24 hours notice for cancelation.

 

Instructions for New Patient Forms: There are 3 options for filling out forms

 

1. Forms can be printed from the website and filled out by hand. 

 

2. Forms can also be filled out on the website by clicking on the blank space next to each field. In the health history please click on any appropriate boxes or mark with an x. (Boxes may be tabbed through.) Please date and sign manually. 

*If you choose to save the form it will save to your computer and not to this website. No information you enter on the form will be stored on this website.

 

** Please print all forms and bring them to your first appointment.

 

3. We also have forms available at the office. If forms are not filled out prior to your appointment, please come 10 minutes early.

 

Please call our office if you have any questions or problems with the forms. 808 596-0133

© 2015 Tanabe & Tanabe DDS INC

1221 Kapiolani Blvd. Suite 515
Honolulu, HI 96814
jmtanabedds@gmail.com
Tel: 808 596-0133

 

After Hour Emergencies

Jon Tanabe 808 286-2099

Marsha Iwahiro-Tanabe 808 371-4716

If you have any trouble accessing our website or filling out our patient forms, please call our office at 808 596-0133 and we will be happy to assist you. You can also click on the Accessibility Link that gives Accessibilty suggestions from the ADA.

This site was designed with the
.com
website builder. Create your website today.
Start Now