Inquiry about medical travels to Japan

Your inquiry about medical travels to Japan will be responded to by Accredited Medical Travel Assistance Companies (AMTAC).

Enter required fields, and click "Confirm" . Regarding the information you sent us by e-mail, we understand you agreed to our privacy policy and will treat it accordingly.

* Sections marked with an asterisk are required.

Person inquiring (First Name) *	This field is required.
Person inquiring (Middle Name)
Person inquiring (Last Name) *	This field is required.
Company name
Gender	Male Female
Age
Country of residence *	Select from the list of countries. This field is required.
City
E-mail address *	This field is required.The E-Mail format is invalid. Please enter again for confirmation This field is required.
How did you find this website? *	From my relative or acquaintance Through a Japanese medical institution Through a non-Japanese medical institution Through a Japanese diplomatic mission Through a foreign diplomatic mission in Japan Web search Website of the Ministry of Foreign Affairs of Japan (Visa for Medical Stay) Other This field is required.
Category of the inquiry	Request for treatment, examinations, or an estimate Questions about MEJ's services Request for a business alliance/cooperation Other
Your relationship with the patient	Yourself Your relative or acquaintance Medical institution Agent or travel agency Other
Patient (First Name)
Patient (Middle Name)
Patient (Last Name)
Patient (Gender) *	Male Female This field is required.
Patient (Age) *	This field is required.
Patient (Nationality) *	This field is required.
Patient (Country of residence)
Description of the inquiry *	As accurately as possible, describe the patient's diagnosis and symptoms, type of currently available medical information, and the name of the medical institution you want to contact. This field is required.
AMTAC *	Please choose your preferred Accredited Medical Travel Assistance Companies(AMTAC). JMHC : Japan Medical & Health Tourism Center, c/o JTB Corp. Emergency Assistance Japan Co., Ltd. I-cell Networks Co., Ltd. Saint Lucia Healthcare Japan Co.,Ltd. All of the above companies This field is required.

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