VEGAN EXAMS

Name ※
Gender ※	MaleFemaleOther
Date of birth ※
Request of appointment, Date and Time Closed：Sat・Sun・National Holidays In case of emergency, you can call us anytime.	First：～ Second：～ Third：～
Purpose of visiting ※If you have any idea which you would like to check, please let us know. Please take the blood and urine tests with fasting for 12 hours except taking water.	Blood and Urine testsDEXA
Health Insurance　※	Having Japanese Health InsuranceNo Japanese Health Insurance. （Having International Health Insurance or tourist short-stay visitor）
Email※
Remarks