Appointment Agreement

Please review and confirm both items below before continuing.

Japanese Health Insurance Verification

A Japanese health insurance card alone can no longer be used for insurance verification.

Please bring ONE of the following:

  1. My Number Health Insurance Card
  2. Eligibility Confirmation Certificate (資格確認書)

If we cannot verify your eligibility at the time of your visit, a refundable ¥20,000 cash deposit is required. This may apply if you are applying for or renewing insurance, forget to bring the document above, or your eligibility cannot be verified for any other reason. The deposit applies each time we cannot verify.

Once you provide a valid document, we recalculate your treatment fee and refund any difference the same day.

Appointment Cancellation Policy

Please note that cancellations made with less than 24 hours’ notice, as well as missed appointments without prior notice, may be subject to a ¥5,500 cancellation fee. This policy helps us provide timely care by making appointment times available to other patients whenever possible.

Thank you for your understanding and cooperation.

Please tick both boxes above to continue.