Tokyo Mother's Clinic

Medical Questionnaire

Please fill out the medical questionnaire after making an initial appointment by email or the online reservation system .Click here.
(From Dec.1st, 2023, the husband (partner) and children can accompany the patient for the first visit.)

Contact Us

TEL:+81-(0)3-3426-1131

FAX:+81-(0)3-3426-1170

Mail Form


4-5-1 Kamiyouga, Setagaya-ku, Tokyo, 158-0098, Japan

Access Map

Contact Us

TEL:+81-(0)3-3426-1131

FAX:+81-(0)3-3426-1170

Mail Form


4-5-1 Kamiyouga, Setagaya-ku, Tokyo, 158-0098, Japan

Access Map