To request copies of your medical record, you may download the Authorization for Disclosure of Health Information, complete, date and sign.
Mail form to:
Shriners Hospitals for Children — Honolulu
Health Information Management Department - ROI
1310 Punahou Street
Honolulu, HI 96826
Be sure to list your phone number on the form so we may be able to contact you.
Every effort will be made to process your request within five business days after receipt of completed authorization and any fees that may be applicable. If we do not have a valid photo ID in our files of the patient/parent/legal guardian who is submitting the request, please include a photocopy of one such as a driver’s license, state ID or passport. Our normal business hours are 8 a.m. – 4 p.m. Monday - Friday. For any questions, please call 808-941-4466.
Shriners Hospitals for Children — Honolulu participates with most major insurance companies and accepts patients with or without insurance. All care and services are provided regardless of the families' ability to pay.
If the child is covered by private insurance or a state funding plan, the hospital will bill and accept reimbursement for services provided at our hospital. You receive a co-payment from your insurance company. However, insurance coverage is not a criterion for care. Any child under 18 with a medical condition that is within the hospital’s scope of services is eligible.
For insurance-related questions, please contact Valerie Matsumura at 808-951-3816 or by email.