Health Insurance Society / Health Screening & Medical Checkup designated by Business Establishments
Reservation Request Form
- Reservations are not confirmed only by submitting this form. We will usually reply to you within 3 business days. In the unlikely event that you do not receive a reply from us after 3 business days, please contact us by phone.
- This form is a reservation request form for "up to 2 persons".For reservations for 3 or more persons, please contact us using the form below.
- This form is only for the application for "Health Insurance Society / Health Screening & Medical Checkup designated by Business Establishments" appointment. For any other inquiries such as changes, cancellations, or schedule changes, please contact us using this form.
Registration form
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