1. HOME
  2. Inquiry form

Inquiry form

Please submit inquiries regarding our hospital using the form below.
Appointments or medical consultations that fall under individual medical practice cannot be made through the inquiry form.
Appointments can be made by telephone.
For general inquiries, please click here.
*Indicates a required field.

The information you entered is displayed. Please click the "Submit" button to send the information below, or click the "Back" button to edit.

Your Name
E-mail Address
Phone Number
- -
 
Message

For information about management of personal information, please refer to our Privacy Policy.