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糖尿病の初診で受診される場合、30分程度お時間をいただきます。
下記に現在の状況を入力いただき送信してください。
糖尿病以外の内科受診の方も初診の際はこの予約フォームよりご予約いただけます。

内容を確認後に当院から電話連絡を差し上げます。
電話連絡をもって予約完了とさせていただきます。
※「*」は入力必須項目です
※ なお予約フォームから診療内容に関する質問をご記入いただいても返信できませんのであらかじめご了承ください。
（数日内に当院から電話連絡がない場合、メール送受信の不具合が考えられます。メールを再送いただくか直接クリニックまでお電話をいただければ幸いです）

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