Inquiry form before your appointment (if you have made a reservation)
- This form is for inquiries about the online medical questionnaire, questions about consultations, and other inquiries. We usually reply within about 3 business days. If you have not received a reply from our clinic after 3 business days, please contact us by phone.
- This form is for inquiries before your appointment (if you have made a reservation).
Registration form
About security
Your inquiry will be encrypted using SSL encryption technology.
Please rest assured that your important information will not be exposed to third parties.