COVID-19 PCR
Inspection application

Please fill in the necessary information in the inquiry form

Note:Please take a photo【Passport】or【Certificate of residence】and send

※(Required input)

Name (in Block)
Mail Address
In Japanese (Furigana)
Sex (M/F)
Date of Birth
Age
Date of Departure
Country of destination
Phone Number
Where to Stay in Japan For Foreigner
Please take a photo Passport or
 Certificate of residence and send