Prenatal Care Physician Referral Form
To avoid delays, please make sure your application is complete.
To refer patients to HMSA’s Prenatal Care Services:
- Print a Referral Form.
- Fill in the patient’s name, telephone number, date of birth, and estimated
Fax or mail forms to:
HMSA’s Prenatal Care Services
1600 Kapiolani Blvd., Suite 920
Honolulu, HI 96814
Fax: 1 (808) 952-4460
Please call 1 (888) 400-2776 toll-free if you have any questions.