Hawaii Physician's Affidavit for Sex Designation Change
Official state formSex designation changeFree downloadLast verified November 10, 2026
Sworn statement signed by a U.S. licensed physician to support a new Hawaii birth certificate with a changed sex designation. The physician signs it, and it is sent with the patient's Affidavit and Application for Amendment of Birth Record.
Who can use this form
- The physician signs this form, not the patient.
- The physician must be licensed in the United States.
- The physician must have a bona fide physician-patient relationship with the birth registrant.
- The office's page does not accept naturopaths.
What to send with it
- The physician's signed and notarized affidavit.
- Send it together with the patient's Affidavit and Application for Amendment of Birth Record.
- The $3 fee applies to the amendment, not to this affidavit.
Where to send it
- Mail to
- Department of Health - Office of Health Status Monitoring Registration/Corrections Section P.O. Box 3378 Honolulu, Hawaii 96801-3378
- State fee
- $3 per amended item (for the amendment, not for the affidavit)
- Typical processing
- Not provided
- Source
- Official government page