Online Booking

Regardless of first visit / return visit, we accept online booking.

Please describe your desired date and time (1st hope / 2nd hope etc) and send it from this form.

We will contact you after checking e-mail.

Please be aware, when using Japanese health insurance, we only accept cash.
We accept credit cards for teeth whitening, cleaning and private treatments.

[Booking Hours]

Mon-Fri
9:00-17:00
(If you want whitening、16:00 is last booking time.)

Your Name  Required 

First VisitReturn Visit

Clinic Card Number 
If you are return visit, please write your clinic card number.

Birthday yearMonthDay

E-mail  Required 

Phone Required 

For the First Visitor, include consulting

For the Return Visitor

[Booking Hours]

Mon-Fri
9:00-17:00

(If you want whitening、16:00 is last booking time.)

convenient dates and times(1st hope) Required
Month day o'clock minutes

convenient dates and times(2nd hope) Required
Month day o'clock minutes

convenient dates and times(3nd hope) Required
Month day o'clock minutes