Reserve

Gran Pro Clinic GINZAWEB Reservation Form

1 Information input 2 Reservation confirmation 3 Temporary reservation completed1 Information input 2 Reservation confirmation 3 Temporary reservation completed

Notes

This form is for WEB reservation only.

Click here for the Reservation Form

No reservation can be confirmed only with this form.
Only after our subsequent phone call to make you confirm your reservation can
the reservation be deemed as being accepted.(Time required: 2 to 3 minutes)

If you make an reservation via mobile e-mails, you may fail to complete the reservation due to the SPF in your mail settings (e-mail refusal from PC due to rejection of spam, etc.). Please change the specified reception settings to receive mails from the domain of [reserve@granpro-clinic.com].Please refer to the homepage of each mobile operator to confirm the setting method.

requiredTreatment
purpose
  • First visit · Follow-up
  • Contents

※As long as you have received a test or treatment at the GP Clinic, the subsequent visit is considered a follow-up, regardless of the length of the interval.
required
Treatment list

Click on each item to learn detailed tests and treatment.
Remarks

If you have any questions about test, treatment, etc., please write down.

required1st
preferred date
  • Date
  • Time
required2nd
preferred date
  • Date
  • Time
RequiredName
  • Name
  • Pronunciation
RequiredAge
RequiredPhone number Time available for answering phone calls
Time available for answering phone calls
RequiredE-mail
address
  • Address
  • For confirmation