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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
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Hawaii Physician's Affidavit for Sex Designation Change | Hawaii Form