Inquiry by email

Please contact us by following form if you have any question or concern about our medical services.

Fields marked with an asterisk are required. Please fill out all fields then click 「confirmation」below.

Name
Email address
Please note that we may call you if our email did not get delivered to you.
Please make sure your mobile mail is set up to accept our email address 「tokyonishi-hp.or.jp」
Telephone Ex:(+123)-456-7890-1234
Inquiry
Confirmation