Kevin B. Kern, MD
American Board Certified in Pain Medicine
American Board Certified in Anesthesia
Home Links Policies Patients Physicians
American Board Certified in Pain Medicine
American Board Certified in Anesthesia
Home Links Policies Patients Physicians
Fax: 877-234-3819 (new)
Email: mpc@mauipainclinic.net
1063 Lower Main St.
Suite C-213
Wailuku, HI 96793
Dear Physician,
The below links are referral forms which can be downloaded. These documents can either be printed and returned to us by fax or simply edited and either faxed or emailed to the number or email above. We recognize these forms do take a few minutes to complete and we recognize your time is valuable. However, this information helps us care for your patient. Please send any additional reports such as EMG/NCS or imaging studies to our above fax so that are best equiped to care for your patients. Thank you for involving us in the care of your patient.
Physician's Referral Forms below:
Inpatient Referral Form-Word Document*
Outpatient Referral Form-Word Document*
Medical Management:Dear Physicians:
Because of limited clinic time, we are unable to write regualarly for C2 narcotics as they require regular refills every 30 days. We will do some medical management of non C2 medications as their refill requirements are much more flexible, however once reasonably stabilized we will return the patient back to their primary care to continue their medications.
Please review our Policy page:
Patient questionaire forms:
Useful Links:
* For those who do not have installed Microsoft's Word software on their computer, Microsoft does provide a Word Document Viewer which is free. This viewer can be used to view and print Word documents, but you will not be able to edit these documents. To install this software, please click on the link below and download the viewer as instructed.
Microsoft Word Viewer
Home Links Policies Patients Physicians