For Healthcare Professionals

About the Referral Process

Referral Process

As a rule, we ask all first-time patients, including those seeking a second opinion, to make an appointment in advance.
*We also accept inquiries directly from patients; however, since the information listed below is required before you can receive care, please consult the hospital you currently attend. If anything is unclear, we will be happy to explain, so please feel free to contact us.

Referral Process

  1. Contact Us by Fax

    If you wish to be seen at our clinic, please first fill out the “Fax Cover Sheet / Appointment Application Form” and fax it to us together with the medical information report (referral letter). Once we receive your fax, we will review it and contact you.
    FAX / 0798-78-7520


    If your case is urgent, we also accept calls at 0798-78-7501, though we may not be able to respond immediately.
    Reception hours: Weekdays 9:00 a.m. – 5:00 p.m.

    Download the fax cover sheet here

  2. Mail the Original Referral Letter and Images

    Please mail the original medical information report (referral letter), imaging CD-Rs, and other materials to our clinic. For the information we ask you to send, please refer to the list below.
    5-5 Koshien-Sanbancho, Nishinomiya City, Hyogo 663-8173, Japan

  3. We Will Contact You

    As soon as the materials arrive, we will assess whether treatment at our clinic is indicated.
    If it is, we will contact the patient, the person in charge at the referring hospital, or the regional medical liaison office to arrange the first appointment. Please note that it may take some time before we are able to contact you.

  4. First Visit

    Please come to the clinic bringing the first-visit application form we sent you and your My Number card (or, if you do not have a My Number card, an eligibility certificate or similar document).

Information to Be Mailed

Note 1: CD-Rs of imaging studies showing how the tumor has changed over time, together with the radiology reports
Note 2: Data showing the trend in tumor markers as well as recent blood urea nitrogen and creatinine values
Note 3: Dose distribution charts, etc.
Note 4: Data showing PT, PT-INR (hemostatic function), CRP, platelet count, and white blood cell count
Note 5: Information identifying the manufacturer, model number, serial number, etc. (this may also be brought with you at the first visit)

*For RFA (radiofrequency ablation), patients with an implanted pacemaker are contraindicated in principle, although treatment may be possible in some cases.
*For diagnostic imaging, particular caution is required for MRI examinations (pacemakers, metal implants in the body, tattoos, etc. are contraindicated).

For Healthcare Professionals