Contact Hospice Hawaii

Address

Contact Hospice Hawaii to learn more about our services
or get involved.

Telephone

Oahu: 808-924-9255
Molokai: 808-553-4310
Fax: 808-922-9161

Email

info@hospicehawaii.org

Hospice Hawaii Administrative

860 Iwilei Road
Honolulu, HI 96817
P: 808-924-9255
F: 808-922-9161

Hospice Hawaii Kailua

566 Papalani Street
Kailua, HI 96734
P: 808-262-4055
F: 808-263-9767

Hospice Hawaii Molokai

P.O. BOX 408
Kaunakakai, HI 96748
P: 808-553-4310
F: 808-553-3183

Physicians Referral Form

Hospice Hawaii Referral Form

Patient Information: Name *
Gender *
Date of Birth *
Patients Phone Number *
Address
Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Clinical Condition(s) *
Primary Contact *
Phone *
Primary Insurance *

Referring Office Section Below

Physician *
Office Contact *
Office Phone Number *
Note or other relevant information

Verification

Please enter any two digits with no spaces (Example: 12)*
This box is for spam protection - please leave it blank:

Hospice Hawaii Events

Upcoming

More

Hot Pursuit

Hot Pursuit - April 14th at Ward Centers
Hot Pursuit is a fun filled day of...
More

Support Groups

Support Groups
Hospice Hawaii's bereavement support groups for adults meet once a month in Honolulu,...
More

Na Hoa Malama

Na Hoa Malama
Na Hoa Malama is Hospice Hawaii’s annual wine dinner gala event. In...

Events

Featured

Hot Pursuit

Hot Pursuit - April 14th at Ward Centers

Hot Pursuit is a fun filled day of festivities. More than just a walk, this “Amazing Race” style event will bring the elements of friendly competition among participants while raising funds to support Hospice Hawaii’s vital programs and services in the community. Participants race along...

Contact Hospice Hawaii

Address

Telephone

Email

Hospice Hawaii Administrative

Hospice Hawaii Kailua

Hospice Hawaii Molokai

Physicians Referral Form

Hospice Hawaii Referral Form

Referring Office Section Below

Verification

Hospice Hawaii Events

Hot Pursuit

Hot Pursuit - April 14th at Ward Centers

Support Groups

Support Groups

Na Hoa Malama

Na Hoa Malama

Events

Hot Pursuit

Hot Pursuit - April 14th at Ward Centers

Our Mission

Latest PortfolIo Items

Contact Hospice Hawaii

Address

Telephone

Email

Hospice Hawaii Administrative

Hospice Hawaii Kailua

Hospice Hawaii Molokai

Physicians Referral Form

Hospice Hawaii Referral Form

Referring Office Section Below

Verification

Hospice Hawaii Events

Hot Pursuit ﻿

Hot Pursuit - April 14th at Ward Centers

Support Groups

Support Groups

Na Hoa Malama

Na Hoa Malama

Events

Hot Pursuit ﻿

Hot Pursuit - April 14th at Ward Centers

Our Mission

Latest PortfolIo Items

Hot Pursuit

Hot Pursuit