Optional Examinations
Change / Add Request Form

  • This form is only for those who have made an appointment (date of consultation) in advance.
  • Reservations are not confirmed only by submitting this form. We will usually reply to you within 3 business days. In the unlikely event that you do not receive a reply from us after 3 business days, please contact us by phone.
  • If you are within one week of the reservation date, we will not be able to accept your application using this form.Please contact us from the "Contact Us" page.

Our clinic will be closed for the New Year holidays from Tuesday, December 30, 2025, to Sunday, January 4, 2026.
Inquiries received during this period will be handled sequentially from Monday, January 5, 2026.
(Please note that inquiries received on or after December 24 may also be handled from January 5 onward.)
We appreciate your understanding and patience.

Registration Form

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