Departments

Visa Reservation Form

Check-up itemsRequired
NameRequired
Surname
Given Name

※Name as in passport
Date of birthRequired
GenderRequired
PregnancyRequired
E-mailRequired
Phone numberRequired

※Please type using half-width characters.
Current address
city
prefecture
Kobe Kaisei Hospital
Card No.

※Only if you have
Preferred date
  • ①
  • ②
  • ③
Date of departure(if determined)
Deadline(if required)
HAP ID (or TRN ID)Required
Passport detailsRequired
No:
Date of issue:
Date of expiry:
Issuing country:
Country of birthRequired
Health case IDRequired
VISA categoryRequired
Passport detailsRequired
No:
Date of issue:
Date of expiry:
Issuing country:
Country of birthRequired
VISA categoryRequired
  • Temporary
  • Rsidence
  • Work to Residence
The length of stayRequired
Number of doses of
COVID-19 VaccinationRequired
times
Remarks
Please list any medical history that required treatment or hospitalization, or any current undergoing treatment.