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Maui Campus
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Health Services Department -
Kamehameha Schools Maui

Elementary School
Bernadette Reiter, RN, BSN
275 'A'apueo Parkway
Pukalani, HI 96768
Phone: (808) 572-3222
Email: Bernadette Reiter, RN

Middle School
Malia Song, RN, BSN
281 'A'apueo Parkway
Pukalani, HI 96768
Phone: (808) 572-4221
Email: Malia Song, RN


High
School
Sue Hardesty, RN, BSN
270 'A'apueo Parkway
Pukalani, HI 96768
Phone: (808) 573-7073
Email:
Sue Hardesty, RN


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.

High School Student Forms

Jump to: High School | Middle School | Elementary School

Athletic Participation Form

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.

High School Forms

For High School health questions, please contact Sue Hardesty, RN at 573-7073.

Cardiovascular Health Testing Parent Letter
Cardiovascular Health Testing Parent Consent
Flu Vaccine Information Sheet 2008-2009
Flu Vaccine Parent Consent
Staff Flu Vaccine Consent
New Invitee - High School (9th-12th Grade) 

Cover Letter New Invitee High School (Explanation of Required Forms)

Health Record Requirements-High School

Permission For Medical Treatment and Release (PTR)

Student Health Record – New Invitee

CV Health Testing Parent Letter

CV Health Testing Permission Form

Athletic Participation Form

Request For Administration Of Medication Form

 
12th Grade-Returning

Cover Letter – Returning Grades 10, 12 (Explanation of Required Forms)

Health Record Requirements-High School

Permission For Medical Treatment and Release (PTR)

Athletic Participation Form

Request For Administration Of Medication Form

 
11th Grade – Returning

Cover Letter – Returning Grade 11 (Explanation of Required Forms)

Health Record Requirements-High School

Permission For Medical Treatment and Release (PTR)

Student Health Record – Returning

Athletic Participation Form

Request For Administration Of Medication Form

 
10th Grade – Returning

Cover Letter – Returning Grades 10, 12 (Explanation of Required Forms)

Health Record Requirements-High School
Permission For Medical Treatment and Release (PTR)
Athletic Participation Form
Request For Administration Of Medication Form
 
9th Grade – Returning

Cover Letter Returning 9th - (Explanation of Required Forms)

Health Record Requirements-High School

Permission For Medical Treatment and Release (PTR)

Student Health Record – Returning

CV Health Testing Parent Letter

CV Health Testing Permission Form

Athletic Participation Form

Request For Administration Of Medication Form

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