PATIENT FORMS

Fill Out Our Patient Forms to
Make Your Visit Easy

Get Comprehensive Dental Care

Brian S Kubo, DDS Inc. has been providing comprehensive dental services to the residents of Waimea (or Kamuela), Waikoloa, the Kohala Coast, Hilo, and the other areas on the Big Island of Hawaii. Visit us today for all your dental ailment needs!

Prior to their first visit to Dr. Kubo, new patients are required to fill out the forms given below. We offer exclusive discounts for senior citizens without insurance.
Adult Registration and Health Questionnaire
Adult Registration and Health Questionnaire
Child and Minor Registration and Health Questionnaire
Child and Minor Registration and Health Questionnaire
Receipt of Notice of Privacy Practices
Receipt of Notice of Privacy Practices
Notice of Privacy Practices
Notice of Privacy Practices
Permission to Correspond Via Email Form
Permission to Correspond Via Email Form
Call us at
808-885-8465
for any dental
emergency!
With 24 years of experience, Dr. Kubo is sure to treat your dental ailments with effective medical procedures.
Office
Share by: