The application form from this
Application form
On having you apply
- You read "a privacy policy" on an inquiry about application and the application and apply after an agreement, and please refer.
- The inquiry about the application may take time for an answer. The dispatch, please feel free to contact us over a telephone.
Medical corporation Fukuji fortune surgery hospital TEL: 073-488-1339
About the input is careful
- ※The seal is a required item. Please input by all means.
- Please input all the katakana with full size.
- Please input a phone number (home or cell-phone) to get of the communication into a phone number column by all means.
- If input is over, please click "the contents confirmation" under the form.
- As contents confirmation screen opens, after confirming input contents, I click "the transmission" and am completion.