Apprication process of quotation to medical and some

other services.

1) First of all, please decide what medical services you wish to            have.

2) Second, which clinic you want,  Kita-Aoyama D-Clinic/D-Clinic  Forum or Imperial Hotel Tower Clinic(=Uchisaiwai cho Clinic.)

3) If you wish to have Medical check-up(=NINGEN Dock ), you can      select one out of two Medical Clinics.

4) If you select NINGEN Dock(=Medical check-up),the inspection        items are slightly different in each clinics. Please check the

     inspection items.

5) If you wish to treat your pains of Herniated Disk quickly in              a day during your stay in Japan, please select Kita-Aoyama            D-Clinic which is very famous for painless laser treatment,              PLDD in Japan.

6) If you wish to treat pains of your legs because of varicose              veins, select Kita-Aoyama D-Clinic again.  Dr.Abo, director              general, will treat it with painless laser in short time in a day.        Dr.Abo is very famous in this field also and often introduced            on TV.  

7) D-clinic Forum is the associated organization in the same                building and various cosmetic & anti-aging treatment.

8) After you selected the medical course, please fill in our

    “Application form” in menu and send it to DJP by fax or E-mail.

9)    As soon as we receive the application form, we will consult              with the clinic and get quotation. We will inform you how

       much it costs medical service fee with actual cost of our

       service fee for matching service and interpreter fee.

10) If you accept and confirm the schedules in Japan, we will ask          you to transfer money to our bank account.  On the appointed        day for medical service in Japan, our English speaking staff or        an interpreter for your mother language will fetch you at your        hotel in Tokyo.   

 We will wait for you in Japan and welcome you !!


Application Form(Please fill in & send it to us)

You can use the form shown below. In this case, you can just fill in your necessary requests and send it by E-mail.

After you complete the form, you will find the button of "comfirming  the content" and "send it"  by E-mail automatically.  

Application Form (for Medical Service)

Example:Richard Smith (Name & Family name)

Example: 2018/02/15 = Year/ Month/ Day )

Example: 2018/01/18 = Year/ Month/ Day )

Example: 2018/11/03 = Year/ Month/ Day )

(Must be filled in)

・Must be filled in

・Must be filled in.

・Must be filled in.

・Must be filled in.

 Please refrain from pressing submit button,"SEND" twice as it will take about 5 seconds till next screen shown.

In case you have any trouble in filling this application form,      please feel free to contact us. Our E-mail number is