Appointments


We accept appointments by telephone (Tel: 03-5486-8440) or on this page.
The items marked with ※ must be entered.
We will send a return mail at a later date. ?You will confirm your appointment by mail.
Since you cannot book an appointment on the next day, moreover, please allow about 1 week to book your appointment.

Consultation hours: 10:00 to 13:30, 15:00 to 19:00
Non-consultation days: Sundays and public holidays
※ If you wish to undergo orthodontic treatment, you can book an appointment every other Sunday.

Name※


Nationality


Sex
Male Female

Languages understood (multiple selections are permitted)
English Japanese Chinese Korean

Address


Telephone number※


Mail address※


Consultation details (details of your preferences, symptoms, etc.)
First visit
Return visit
Regular examination


Preferred date 1
month day hours minutes
Preferred date 2
month day hours minutes
Preferred date 3
month day hours minutes

Preferred treatment (multiple answers allowed)※
Implant treatment (if you have any lost tooth)
Periodontal treatment (if you have any loose tooth, or if you have bleeding and a discharge of pus from the gums)
Orthodontic treatment (if you worry about teeth alignment)
Esthetic dentistry treatment (if you wish to improve the look of teeth with crowns)
Whitening treatment (if you wish to whiten the teeth without grinding them down)
Other (medical examinations, caries, etc.)

Use of parking space
Yes
No



Our clinic staff can speak Japanese and English.