Kamehameha Schools Health Forms

Health Services Department
Maui Campus

Downloadable Forms

Forms linked from this page are saved in Adobe PDF format. You need to have the corresponding software installed on your computer to access the files. (Free Adobe PDF Reader software available here.) Select the desired format for your computer.

Elementary School Student Forms

Jump to: High School | Middle School | Elementary School

Authorization To Release Information
Used to authorize release of reports, information to Kamehameha Schools.

Authorization To Release Student Health Records
Submit to Health Services Department when you need copies of medical information in KS Medical Records.

Request For Administration of Medication
Necessary when your child needs to carry/take any medication (over-the-counter or prescription) at school.

Elementary School

For Elementary School health questions, please contact Lu Kepler, RN at 572-3222.

New Invitee Elementary School (Grades K-5)

Cover Letter – New Invitee Elementary - (Explanation of Required Forms)

Health Record Requirements - Elementary School

Permission For Medical Treatment and Release (PTR)

Student Health Record – New Invitee

Middle School Student Immunization Record

Request For Administration Of Medication Form

Grades 1, 2, 3, 5 – Returning