MENU

CLOSE

APPOINTMENT REQUEST

Request a first appointment

You can send this form at any time, including evenings and days we are closed. Only your name and email address are required. We reply in English on the next clinic day to confirm the date and time.

We reply to this address in English. Our reception team speaks Japanese only, so we contact you by email, not by phone. You will also receive a confirmation email.
Preferred date and timeOptional
Clinic days are Tuesday, Wednesday, Friday and Saturday, 10am–6pm (Japan time). We may not be able to offer your first choice.
This helps us plan treatment so that it can be finished before you leave, where the condition of the tooth allows.
What is the problem?Optional
Treatment on the day of the first visitOptional
Whether this is possible depends on the condition of the tooth. If treatment is carried out, the treatment fee is charged in addition to the first-visit fee (see Treatments & Fees).
How did you find us?Optional
Age group and sexOptional

Your first visit (private; Japanese health insurance cannot be used)

Includes: consultation, medical history, oral examination (including a periodontal check), X-rays and intra-oral photographs

Fee: ¥28,000 (incl. tax)

Time: we reserve about 2 hours

We will send a confirmation email to this address.
Please check that it is correct.

After you send this form, we contact you on the next clinic day to confirm the date and time. Your appointment is not confirmed until you hear from us.

You will first receive an automatic acknowledgement by email. A reply from the clinic, in English, follows on the next clinic day.

We see patients by appointment only, and treatment is private (self-pay). Clinic days are Tuesday, Wednesday, Friday and Saturday, 10am–6pm; closed Monday, Thursday, Sunday and public holidays.

If it is urgent, please say so in your request. Our reception team speaks Japanese only, so please contact us by email (info@kazama.dental) rather than by phone.

By email
info@kazama.dental

Clinic days: Tue, Wed, Fri, Sat 10am–6pm (Japan time) / Closed Mon, Thu, Sun and public holidays

Written and medically reviewed by Ryunosuke Kazama, DDS, PhD, Director
Part-time Lecturer, Institute of Science Tokyo (former Tokyo Medical and Dental University); Clinical Professor, Matsumoto Dental University
Last updated: 11 November 2026