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We will not use information provided by customers for other purposes. Refer to our company’s privacy policy for details on the handling of personal information.

Please note that there may be cases where we are not able to reply your questions or provide a prompt response depending on the enquiry content and situation.

*Items marked with an asterisk are mandatory.

*Nature of inquiry / comments
Name in Japanese
*Name in English
*Email Address
*Email Address (for verification)
*Name of Hospital,
Company, Organization
Department
Tel No.
Fax No.
Postal Code (Example: 160-0023)
Address

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Contact us