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For those who are undergoing a medical examination for the first time

You can download the questionnaire by clicking the button below so that you can fill out and bring the questionnaire at home so that you can shorten the reception time and grasp the condition of the person who received the examination as soon as possible. By having the vote submitted at home in advance, the reception time for the first visit will be shortened. Please use it if you are going to see a doctor for the first time.

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If you are a first-time visitor, please come directly to the clinic as it is not an appointment.

Interview sheet
はじめて受診される方へ
Consultation hours
診療時間
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▲ Saturday afternoon outpatient hours are until 17:00.

Outpatient examination schedule
外来診察予定表
Note) The doctor in charge of outpatient examination may change in a hurry.
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* Monday morning outpatient consultation doctor Guo is available only on the 1st, 3rd, and 5th Mondays
​ * Saturday morning outpatient consultation doctor Kiyoto is only on the third Saturday
​Interview sheet
問診票

If you are going to see a doctor for the first time at our hospital, please fill out the questionnaire and the consultation application form. You can download the questionnaire by clicking the button below so that you can fill out and bring the questionnaire at home so that you can shorten the reception time and grasp the condition of the person who received the examination as soon as possible. By having the vote submitted at home in advance, the reception time for the first visit will be shortened. Please use it for the first visit.

​Computer direct editing
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Click the download button on the paper button below, and use Acrobat Reader to enter and edit the file downloaded to your computer directly on the computer for the medical examination application form and questionnaire. You can use the paper printed by the printer after inputting as the documents to be submitted. Even if there is an input omission, you can write it with a ballpoint pen after printing with a printer.

​​ * Acrobat Reader from Adobe Systems Incorporated is required for direct computer editing. (Free)

1. 1. Open the medical examination application form or questionnaire file downloaded with Acrobat Reader.
2. Enter each item on the screen of the medical examination application form and questionnaire.
3. 3. Please print in A4 size (paper direction is vertical).
Four. Please present the completed questionnaire and medical examination application form to the reception desk along with your health insurance card.
* If you have a medical examination due to a traffic accident or injury or illness during work or commuting, please be sure to inform the receptionist.

Download After printing Paper editing
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​Click the Print button on each form of the medical examination application form and questionnaire, and fill in each item on the printed form with a ballpoint pen or the like.

1. 1. Please print in A4 size (paper direction is vertical).

2. Please fill in the contents.
3. 3. Please present the completed questionnaire and medical examination application form to the reception desk along with your health insurance card.
* If you have a medical examination due to a traffic accident or injury or illness during work or commuting, please be sure to inform the receptionist.

Medical corporation Dankoyasu Okurayama Neurosurgical Clinic

 

045-548-1117

3-41-22 Okurayama, Kohoku-ku, Yokohama

Okurayama Medical Building 3rd floor

Exit Okurayama Station on the Tokyu Toyoko Line and walk 3 minutes on Elm Street on the right side with the Tokyu Store in front.

The first floor of this building is FamilyMart

traffic guide

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交通案内
For those who have forgotten their health insurance card
保険証をお忘れの方へ

If you have forgotten your health insurance card, we will make a deposit. Please note that payment will be made when you bring your health insurance card at a later date.

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