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University of Hawaii University Health Services Nearest FORM1710 East West Road | Honolulu, Hawaii 96822 Phone (808) 9568965 FAX (808) 9563583 Secure email via File Drop: www.hawaii.edu/filedrop Recipient:

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Step 1: Visit the UH Health Services website or contact them directly to inquire about the form.

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Step 5: Submit the filled-out form to UH Health Services through the designated method (online, in person, etc.).

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Students enrolled at the university who require medical services or treatment.

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