Skip to main content
Hawaiʻi Pacific Health Logo

Preparing for Your Stay at Kapiʻolani

Please complete the form below and we will email you a confirmation with additional information to help you prepare for your delivery.

Also take a moment to read our privacy policy to understand how we manage your personal information.

Maternity Pre-Register
PATIENT INFORMATION
Pediatrician's name can be changed at the hospital.
Emergency Contact Information
Insurance Information
Do you have health insurance? *
Insurance Details
Is the subscriber employed? *
Would you like to add secondary insurance coverage information?
Secondary Insurance Information
Is the subscriber employed? *