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Hawaii PA-3: Disability Parking Permit Application

Hawaii residents use form PA-3 to apply for a temporary (red), long-term (blue) or Disability Paid Parking Exemption Permit (green) placard, or special license plates. The Disability and Communication Access Board issues it statewide through the four counties. A clinician meets it when a patient's walking limitation needs certification on Side 2, which the applicant then takes to a county issuing site.

Who completes it

The applicant completes Side 1 first. A physician, physician assistant (AMD) or advanced practice registered nurse completes Side 2: items 13, 14 and 16 are required, 15 and 17 optional.

Submitting and payment

How to submit it
The provider returns the completed original to the applicant and may keep a copy for the chart. First-time and temporary applications go to a county issuing site; long-term renewals and green placard requests are mailed to DCAB.
Who pays
Applicants pay a fee for temporary placards, while first-time blue and green placards are free; the form does not address payment for the certification.

Good to know

  • Item 13 needs at least one condition in (A), such as arthritic, oncologic or renal disease, lung disease or AHA Class III/IV cardiac disease, and at least one functional impact in (B).
  • Vision impairment, mental illness, old age, infancy, deafness, upper limb amputation, pregnancy and behavioral, learning, intellectual or developmental disabilities do not qualify on their own.
  • The certifier's signature is valid for 60 days, or 180 days for long-term renewals. A digital signature is accepted, but faxed or photocopied signatures are not.
  • Item 17 certifies the green meter-exemption placard: the applicant needs a valid driver's license plus inability to reach 42 inches, approach a meter, or handle payment with both hands.

Get the official form

Download the current version from the source each time; forms change without notice.

Person with a Disability Parking Permit Application Form

Official pagePDF

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

Who can sign Hawaii form PA-3?

A licensed practicing physician, a physician assistant (AMD) or an advanced practice registered nurse. The medical license must be a Hawaii license, or a U.S. Armed Services license for providers stationed in Hawaii, and the certifier circles a license type such as MD, ND, PO, APRN or AMD.

How long is a Hawaii temporary disability placard valid?

Temporary (red) placards last no more than six months; the certifier marks one to six months in item 14. If the disability lasts longer, a new certification can be made. Long-term (blue) placards require a disability expected to last at least six years.

Can the patient skip appearing in person for a Hawaii placard?

Yes, if the certifier marks item 15, certifying that the applicant is exempt from applying in person for a medical reason. An authorized representative then presents the applicant's original ID with the completed original form at the county issuing site.