Is it your first time visting our clinic?
YesNo, I have visited before
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Please bring your Japanese health insurance card once each month. If the patient is your child, please bring his or her yellow childrens' medical treatment card.
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Please bring your Japanese health insurance card. If the patient is your child, please bring his or her yellow childrens' medical treatment card.
How can we help you?
Cavity treatmentCheck up and cleaningGum painOther (please visit)
When are you available to visit? We will contact you with available dates and times on your chosen days of the week.
AMPMEither is fine
Is it your first time visiting Yamanaka Dental Clinic? The amount of time needed for your consultation changes depending on whether it is your first visit or not.
Yes, it is my first timeNo, I have visited before
Please enter your patient number if possible