Appointments by mail

Our clinic accepts appointments by email(first-time visitors only).
Upon receiving your reservation via email, we will confirm either by email or phone.
If we have not contacted you within 2 days of making a reservation or inquiry, you should call us directly(03-5643-9855).

These are required field.

Name ※必須 （ex: John Smith）
Phone ※必須
（ex: 090-1234-5678）
E-mail ※必須
（ex: kokoro-core2@aroma.ocn.ne.jp）
E-mail
(confirm)
（ex: kokoro-core2@aroma.ocn.ne.jp）
Preferred Time 1st choice
 （ex: 4/3imon））


2nd choice
 （ex: 4/4itue））
Please enter requests or questions