Forms
You may submit all forms by mail, email, fax or in person to:
Pu‘ulu Lapa‘au
Hawai‘i Program for Healthcare Professionals
200 North Vineyard Boulevard
Building B, Suite 271
Honolulu, Hawaii 96817
Fax: (808) 593-8999
Email: maryann.lentz@hawaiiphp.org
Weekly Meeting Log
Travel Request Form
Release of Information Form
Worksite Monitor Form
If sending by email, please use this link to send with HIPAA compliant security:
Pu'ulu Lapa'au/Upload
Please remember that some forms have specific due dates, such as the weekly meeting logs and the travel request forms.
Pu‘ulu Lapa‘au
Hawai‘i Program for Healthcare Professionals
200 North Vineyard Boulevard
Building B, Suite 271
Honolulu, Hawaii 96817
Fax: (808) 593-8999
Email: maryann.lentz@hawaiiphp.org
Weekly Meeting Log
Travel Request Form
Release of Information Form
Worksite Monitor Form
If sending by email, please use this link to send with HIPAA compliant security:
Pu'ulu Lapa'au/Upload
Please remember that some forms have specific due dates, such as the weekly meeting logs and the travel request forms.