(Complete medical check-up)


NINGEN Dock is "Complete medical check-up" or "Comprehesive       medical examination". We cordially suggest you to have NINGEN Dock in Japan, if you  visit Japan while you stay. 

Major purpose of complete medical checkup is to detect the

physical or mental change that shows existing or future disease

which may  be caused by even his/her present lifestyle.  

If some unusual change is detected, we have a chance to prevent    the occurance of disease at an early stage. In this way we may be  able to get a handle on a problem when it's small.

1) Kita-Aoyama D-Clinic (One day medical checkup) Medical

    treatment of Helniated disk or Removal of varicose vain by laser.

2) Imperial Hotel Tower's "Uchisaiwai-cho Clinic" (One day or Two         days checkup:stay one night at Imperial Hotel for two persons ) 


 We need your information how long you can  spare your time for your         medical check-up(NINGEN Dock) and/or medical treatment in Japan

Questions for  arrangement of your medical check-up and/or  medical treatment

  • 1

             Your itinerary in Japan 

    a) Arrival day in Japan      b) Leaving day from Japan

    c) How long will you stay in Japan as tourist or for business trip

    d) How many days can you spare your time for NINGEN Dock or
        medical treatment which you wish to have in Japan.

    e) Where will you visit in Japan for tourist or business

    F) Where will you stay in Japan? Please let us know the name.

  •   2                
    Medical check-up

             1) One day course?   2) Two days course?   

  • 3
      Medical treatment

             1) Medical treatment for removal of varicose vain or Herniated       disk by painless laser operation at Kita Aoyama D-clinic will       be completed within about one hour in a day and can go            back to your hotel on same day.

             2) Anti-aging & cosmetic treatment at D-Clinic Forum will be           completed in a day usually, however, some other services                may require  periodical treatments to follow.


             3) One night stay at Imperial Hotel Tower Clinic is a twin room       for two persons of couple or partners,However, if you wish to     stay alone there,  the room fare will be fairly higher for the         single use.

 Please send your infomation or any queries to Fax number      shown below

 Fax : +81-45-642-7910


Application Form (for Medical service only)

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.

・Must be filled in.

 Please refrain from pressing submit button,"Confirmation & 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