Patient Portal Form

Patient Portal Registration:

To become a member all you need to is an email address and computer and\or Smartphone that has an Internet connection.

Completed the information on the form below, sign the form and give to a Maui Medical Group Representative. We will register you in the Portal and the Portal will send a link to your email to complete your registration.

All request must be made in person and a valid form of identification such  as a Hawaii Driver’s License or State ID will be requested.

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