Hawaii sexually transmitted diseases form 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient's last name, first name, middle initial, and any aliases in the designated fields. Ensure accuracy for proper identification.
3. Fill in the date of birth, age, sex, race, and ethnicity. Indicate if the patient is pregnant and provide gestation weeks if applicable.
4. Complete the marital status and family planning sections by selecting the appropriate options.
5. Input the patient's address and contact information accurately to facilitate follow-up communication.
6. In Section I, document the diagnosis and treatment details for each STD. Specify treatment dates and select appropriate treatments from the provided options.
7. If applicable, list casual or steady sex partners in Section III with their details including name, address, phone number, and whether they were examined or treated.
8. Finally, review all entries for completeness before submitting via fax or mail as indicated in Section V.

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