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Application Form for a Patient

Update : 2023-09-13

Before submitting the application, please carefully read and understand the terms and conditions for receiving treatment at Cancer Institute Hospital of Japanese Foundation for Cancer Research.


Your treatment will be started at Cancer Institute Hospital, supposing that you have a visa that assures you of enough length of stay in Japan. Please make sure that your visa allows you to stay in Japan for an enough period. For further information, please go to our Traveling from Overseas and visit website of the Ministry of Foreign Affairs of Japan.

Language and interpreter

If you do not speak Japanese or English, you need to be accompanied by a qualified interpreter at all times during your hospital visit, 24 hours a day during hospitalization. For this reason, as a general rule, we ask you to stay in a private room with your interpreter. If you speak English, you don’t have to bring an interpreter, but we still ask you to stay in a private room during hospitalization because we will install an interpretation phone device (speakerphone) in your room.

Deposit for hospitalization

When you are scheduled to get admitted for inpatient medical care, International Patient Services will provide you with an estimate of your total fees and charges for your hospitalization. You must send the full payment directly to our designated bank account before the date of your admission.

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