Online Contact Form

After entering the required fields, please click the "Confirm your entry" button.
Please note that all fields marked with "Required" are required.

Type of Inquiry

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About our medical services

Message/ Details

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Full Name

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Phone Number

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Email Address

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*Email addresses from certain domains, such as yahoo.com, may not be accepted. If you do not receive an auto-reply email, please use a different email address or contact us by phone.

After submitting this form, you will receive an auto-reply email from Central Japan International Medical Center.

If you do not receive an auto-reply email, it is most likely that your email address was entered incorrectly or that it has been sorted into your "Junk/Spam Mail" folder. Please try again or check your Junk/Spam mail folder.