Second Opinion Services Procedures

1. 1

   Inform your physician that you will be seeking a second opinion

   If you would like to receive a second opinion, please inform your primary physician and ask them to prepare a referral letter as well as any examination data. Please be sure to confirm when you will be able to obtain the requested documents.

2. 2

   Print and complete the application form

   If you accept the terms of our second opinion services, please sign or put your seal on the form. Except for underage patients, the consent form is also required if family members will be applying for consultation.

   • Please inquire with our primary physician if you are unsure of which division to consult.
   • If you are unable to print the forms, please request them by phone.

   Download

   • Download
   • Consent Form

3. 3

   Send your application

   After filling out the application form, please send it to the fax number printed on the upper right of the form. Forms can also be mailed.

   • We may contact you to confirm your application.

4. 4

   Arrange consultation date and time

   If your application is accepted, your consultant will be chosen from among our doctors based on their speciality. (If your application is not approved, the bureau will contact you by phone.)
   The date and time of your consultation will be coordinated with your consultant's schedule.
   Once your consultation date and time are confirmed, we will contact you.

   • Upon receiving your application, it may take over a week before you are contacted regarding your consultation date and time.

5. 5

   Send necessary documents

   Send all documents to the following address. Please use an express courier service or registered mail (with tracking).

   • Other than prepared slides, submitted materials will not be returned.

   Documents

   • Application form mailed or faxed to 03-5563-3865
   • Referral letter
   • Referral letter
   • Consent form (if the family of the patient will be receiving the consultation)
     • exculding underage patients
   • If the patient is unable to sign the consent form due to their medical condition, please prepare a document that proves said condition.

   Address

   Keio University Hospital Second Opinion Services 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 Direct Number:03-3353-1139

6. 6

   Day of Consultation

   On the day of consultation, please visit Reception Window 11 at least 20 minutes before your appointment time.
   On the day of consultation, please visit Reception Window 11 at least 20 minutes before your appointment time.

   Floor Map

   • If the consultation is for an underage patient, please present both the patient's and their guardian's health insurance card.

7. 7

   After Consultation

   After your consultation, please take a number at the Outpatient Cashier counter (Reception Window 20) and pay your bill at an automated payment machine.
   A report will then be made by your consultant and mailed to your home. A copy will also be sent to your primary care physician.