Forms
You may submit all forms by mail, email, fax, our secure web form, 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
Email: maryann.lentz@hawaiiphp.org
Fax: (808) 593-8999
PDF Forms Under Construction
We are working to make forms easier for you. These are the correct forms. The signing feature does not yet work, so you do need to print and sign the results.
Application (fillable) - for new or returning participant
Weekly Meeting Log
Travel Request Form (fillable)
Worksite Liaison Form (fillable)
You can now upload completed PDFs via our secure form from Paubox.
Note: You do not receive notice that it was sent, however, we will respond directly to you right away.
Please remember that some forms have specific due dates, such as the weekly meeting logs and the travel request forms.