At Molokai Community Health Center, we believe that financial challenges shouldn’t stop you from getting the care that you need. Consistent to our mission and values, MCHC staff can offer insurance coverage options and financial assistance in a number of areas, and help make sure that the quality of care you need comes at a price you can handle. We offer discounted fees for our services and function on a sliding fee scale.
If you seek care but do not have insurance or are under-insured, please reach out to our team to learn more about our program for you and your family. If you would like to apply for our Discount Program, click the link below for the application and list of supporting documents to submit with your application.
For more information, call 808-553-5038 to speak with one of our Registrars to get you set up today!
New Patient Forms
- Patient Registration Form
- Request for Information Form
- Consent & Acknowledgement Form
- Consent to Treat a Minor
Other Forms
Join our ‘Ohana today! At Molokai Community Health Center, our vision is that all people have optimal physical, mental, and spiritual health. With this guiding us, we provide our patients with comprehensive care all on one single location to meet both your health needs and convenience.
As a Patient Centered Medical Home, we are committed to providing same day appointments and even offer expanded hours of care to meet your needs.
To see our services and meet our Provider Team, CLICK HERE.
To get started on registering as a New Patient, CLICK HERE.
To learn more about our Discount Program, CLICK HERE.
For ongoing communication and support with your PCP, learn more about our Patient Portal, CLICK HERE.
To make an appointment call 808-553-5038.
If you are deaf, hard of hearing, or do not use your voice to communicate, you may contact us via 1-866-440-9140 or other relay services.
A recipient of services shall be provided with adequate and humane care and in the least restrictive environment, pursuant to an individualized service plan. When appropriate, a recipient’s nearest kin or guardian shall be involved in the treatment/service plan.
Patients have the right to know of the variety of services that may be available and to participate in the planning of treatment.
Patients may refuse treatment at any time, and patients have the right to be informed of the consequences resulting from the refusal of treatment.
Patients will receive confidential treatment; all clinical records and client information are protected by law, regulations and center policies. For the purposes of funding, certification, licensure, audit, research or other legitimate purpose, your clinical record may be used by the person conducting the review to the extent that is necessary to accomplish the purpose of the review.
Patient information released to or requested from other sources requires your written consent. Patient records can be subpoenaed by court order and does not require your signature for release of information.
Patients have the right to review, and obtain a copy of your clinical record in accordance with MOHC’s policy.
We are required by law to maintain the privacy of your health information and provide you a description of our privacy practices. We will abide by the terms of this notice.
In the case of suspected child abuse or neglect, MOHC is required by the Abused and Neglected Child Reporting Act to report any suspected incidents of neglect or abuse. MOHC also has the ethical obligation to report suspected maltreatment of senior citizens or adults.
If at any time patients present a clear and present danger to yourself or to others, MOHC’s staff may release information that is required to protect you or others.
MOHC may restrict or terminate delivery of services to patients who have been evaluated and determined as posing a serious physical threat to staff or others.
Do you love your provider? Or maybe your visit didn’t go quite right? Please let us know. Your feedback helps us to deliver the best care possible.
Give us a call at our Patient Feedback Line at 808-660-2617 or fill out the form below. Someone from MCHC will be in touch with you personally.
Please note: If you are a MCHC patient and need prompt medical advice, please call our Registered Nurse at (808) 553-5038, Option 9.
please ask any staff member to contact the MOHC Director for assistance, or call (808) 553-5038.