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Visit Intake Form

The Visit Intake Form is the first step in setting up a Customized Group Visit, and should be submitted no later than 3 weeks prior to your visit.  Additionally, in order to prepare for visits, all visitors should complete the NHSS Adult Visitor Waiver or NHSS Youth Visitor Waiver.

Please submit completed forms to the NHSS Community Outreach Coordinator, Ileana Ruelas at

If you have any questions or have other necessary accommodations that we must consider, please call us at 808.956.3805.

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