Reservation – Submission Complete

01. Enter Information
02. Confirm Details
03. Submission Complete
Patient ID Number
Required
Full Name
Required
Furigana / Phonetic Name
Required
Date of Birth
Required
Email Address
Required
Confirm Email Address
Required
Postal Code
Required
Address
Required
Phone Number
Required
Expected Delivery Date
Required
Number of children
Required
Required

For confirmation, we may contact you shortly to confirm the details.
If you do not receive a reply email within 24 hours, please contact us by phone.
Inquiries should be made during our consultation hours.
If your inquiry is submitted on a holiday or outside business hours, we will respond on the next business day.

If you do not receive a confirmation email:

Your reservation may not have been sent successfully.
lease try submitting again, or contact us by phone.
Reservation Line:044-411-3824
Inquiries should be made during our consultation hours.

If you have entered the wrong information:

Please contact us by phone.
Reservation Line:044-411-3824
Inquiries should be made during our consultation hours.