At Koyasu Neurosurgical Clinic, we provide medical care and examinations for patients introduced by regional medical institutions.
Regardless of neurosurgery, we also accept requests for various imaging tests in each clinical department area.
For the image inspection you requested, we will make full use of the highest standard equipment and provide the inspection results to help the teachers' diagnosis. We will also cooperate with regional medical institutions to provide medical support to your patients.
To teachers who introduce patients
At Koyasu Neurosurgical Clinic, we provide medical care and examinations for patients introduced by regional medical institutions.
Regardless of neurosurgery, we also accept requests for various imaging tests in each clinical department area.
For the image inspection you requested, we will make full use of the highest standard equipment and provide the inspection results to help the teachers' diagnosis. We will also cooperate with regional medical institutions to provide medical support to your patients.
To teachers who introduce patients
Inspection request form
If you do not have the inspection request form of our hospital, please download the PDF file of the inspection request form on the right.
You can also print the PDF file inspection request form with a printer that can be printed on a PC by clicking the print icon in the upper frame of the PDF.
If you contact the general affairs of this hospital from the teachers who are considering the inspection request continuously, we will send you the inspection request form. Please tell us.
Inspection request form
If you do not have the inspection request form of our hospital, please download the PDF file of the inspection request form on the right.
You can also print the PDF file inspection request form with a printer that can be printed on a PC by clicking the print icon in the upper frame of the PDF.
If you contact the general affairs of this hospital from the teachers who are considering the inspection request continuously, we will send you the inspection request form. Please tell us.
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.
If you are a first-time visitor, please come directly to the clinic as it is not an appointment.
Interview sheet
Consultation hours
▲ Saturday afternoon outpatient hours are until 17:00.
Outpatient examination schedule
Note) The doctor in charge of outpatient examination may change in a hurry.
* 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
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
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
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
For those who have forgotten their health insurance card
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.