For Our Patients

Authorization for Maui Medical Group to Use or Disclose My Health Information

Please download, fill out, print and send the form to request copies of your medical records to:

Maui Medical Group
Medical Records Dept.
2180 Main Street
Wailuku, HI 96793

*Fees may apply

Phone (808)243-2307 / Fax (808)243-2341

Any request for records will take 5 to 7 Business Days after the receipt of authorization.

Download Form