ご予約・お問い合わせ | 【心臓画像クリニック飯田橋-CVIC-】心臓MRI検査・心臓ドック・画像診断のスペシャリストチーム

After confirming your reservation date, please download the following documents, fill them out, and return them to us.

(1) Passport photo of the patient

(2)Reception form/consent form/questionnaire (2 pages total)

　　　　　Chinese version PDF　　　　　English version PDF

◆Please be sure to fill out the form and return it at least 3 days before the test date.

◆Please enter your name in English in the name field.

◆Please bring the originals of your "passport" and "reception/consent form/questionnaire" on the day of the event.

contact@cviscience.com

件名：事前資料の送付

本文：受診者名／予約日／添付ファイル

Mail

Please download the documents below and read them well in advance of the test date to provide information and explanations to patients.

(3)Precautions when visiting the doctor

(4)How to spend time in the hospital (Chinese)

Please be sure to read this before filling out the reservation application form.

Sunday is set aside as a dock-only day for dock inspections only.
This is a recommended schedule for those who have undergone a medical checkup, so you can have a detailed consultation with the doctor.
◆Reception hours: 8:30/9:00/9:30/10:30/11:30/12:30

If you would like to schedule your appointment on a weekday, we would appreciate it if you could provide us with as many possible dates and times as the times will vary depending on availability.

Note: If you have metal in your body, such as a stent, we will only guide you on weekdays (if a cardiac MRI test is changed or added to a coronary artery CT contrast test based on the doctor's judgment and the patient's consent) there is).

If the patient is a foreign national, we will arrange for a CVIC-designated interpreter at the time of reservation.
◆Only on the day of the test (once): ¥44,000 (tax included) per patient
◆On the day of the test + comprehensive result explanation later (2 times): ¥66,000 (tax included) per patient
◆If you wish to add a result explanation at a later date after paying on the day of the test: Additional ¥44,000 (tax included)

Note: The conditions for ``CVIC interpreter arrangement: not required'' are as follows.
Only certified interpreters currently affiliated with CVIC certified agencies are available.(Excludes those with medical qualifications in Japan).
If it is discovered that the interpreter has submitted a false declaration or has no experience in interpreting at CVIC, and CVIC determines that the interpretation is/or may be insufficient, regardless of whether it is done in advance or on the day of the test, the test may be canceled midway through. In addition to changing the order of testing and restricting reservations from the agency/interpreter, a cancellation fee of 100% of the testing fee or a separate doctor's consultation fee of ¥33,000 (tax included) will be charged.

[About agency contract]We will make a comprehensive and fair decision on whether or not to request a CVIC-certified interpreter based on the track record of your company and agent, the details of the transaction, and the condition of the patient and agent. I am. For new corporations, your past background is completely irrelevant (coordinator and interpreter experience at other companies, hosting medical courses, obtaining private qualifications, belonging to organizations, etc.). Please note that we cannot sign an agency contract after several medical checkups.
Please note that since the transaction record has been over several years since COVID-19, the record at CVIC will be restarted.

Interpreters arranged by our hospital are not always on-site, so please be sure to notify us in advance if you would like one.
Since cardiac examinations directly affect life and health, we ask that you understand the importance of interpreting to avoid medical accidents and troubles caused by poor interpreting skills.

Translation fees vary depending on the content of the dock plan.
◆Premium Dock/Plus: ¥66,000 (tax included)
◆Heart + Brain Checkup Plus: ¥60,500 (tax included)
◆Heart Checkup Plus: ¥48,400 (tax included)
◆Various brain check plans: ¥26,400 (tax included)

Note: The conditions for "CVIC report translation: not required" are as follows.

If the translation is done by an acquaintance or an agency, it must be done by a translator who has been examined and certified by CVIC and who is registered. Additionally, CVIC cannot be held responsible for the contents of test results reports that have not been translated by CVIC. We are unable to answer questions from patients.

*At medical institutions in Japan, many test reports for overseas residents are issued, and the translations are done by acquaintances or agencies, so recently there have been accidents due to large differences in translation.It is now reported. In response to this report, CVIC has decided to perform all report translations from 2019.

The result report will be mailed to the agent's address or designated destination (in Japan) 2 weeks to 1 month after the test (domestic shipping costs are included in the dock fee). If you wish to have your report shipped to an overseas address or file sent by email, additional charges will be incurred, including administrative fees.

◆In Japan: Free of charge

◆Overseas EMS *As of July 2023

・Zone 1: China, South Korea, Taiwan　　　　　　　　　　　　　¥4,400 (tax included)

・Second Zone: Other Asia ￥5,500 (tax included)

・Third Zone: Oceania, Canada, Mexico, Middle East, Europe ¥9,900 (tax included)

・Zone 4: United States (including overseas territories such as Guam)　　　　　　 ¥12,100 (tax included)

・Zone 5: Central and South America (excluding Mexico), Africa　　　　 ¥11,000 (tax included)

◆Send the result report in PDF: By language including Japanese 　　 Each¥4,400 (tax included)

◆After confirming your reservation date, we will send you an invoice via email. Please pay at least one month before your reservation date. *If the reservation date is less than one month old, the invoice is due within 3 business days (excluding Saturdays, Sundays, and holidays). If payment cannot be confirmed, we will cancel your reservation without prior notice.

[Payment methods available for advance payment]
①Bank transfer, ②Credit card (Visa/Master/AmericanExpress/JCB/DinersClub/Discover)

◆If a proxy is making the transfer, please use the patient's ID and name to make the transfer.
◆Transfer fees will be borne by the sender. Please keep your transfer statements, transfer history, and credit card payment statements in place of receipts (if you wish to receive them separately, you will be charged a processing fee of ¥1,100 including tax).

Additional tests may be required depending on the results of the interview on the day, or additional tests may be required at the patient's request, but as a general rule, payment will be made at the counter on the day.
If it is difficult to pay on the day or if you would like us to issue a separate invoice, we will charge a processing fee of ¥11,000 (tax included) in addition to the inspection fee that will be incurred on the day.

[Example of testing costs incurred on the day]
◆If you change from MRI to CT at the consultation stage on the day of the test (no MR imaging): ¥27,500 (tax included)
*Includes cases where MRI cannot be performed
◆If a non-contrast MRI test is changed to a contrast-enhanced MRI test at the consultation stage on the day of the test: ¥37,400 (tax included)
◆If a CT scan is required after the test and both MRI and CT are performed on the same day *A: ¥58,300 (tax included)
◆If you wish to add additional parts to be photographed (there are no specific settings in the price list) *B: ¥55,000 (tax included)
◆Additional translation fee when *A or *B occurs: ¥33,000 (tax included)
◆If you want an image CD sooner than usual, etc. : ¥22,000 (tax included)
◆Additional output of inspection results (image CD + report): ¥7,700 (tax included)

[Payment methods available at the counter on the day]
①Cash, ②PayPay

③Credit card (Visa/Master/AmericanExpress/JCB/DinersClub/Discover)

*Cards with only the UnionPay mark cannot be used, but payments can be made if they have a compatible brand mark such as Master.
④Electronic money (Transportation cards such as Suica and PASUMO / iD / QUICPay / Apple Pay / dPay / PayPal, Alipay / WeChat payment)

◆Until 20 days ago:If you contact us at least 20 days before the reservation date (inspection date), you can change the date and time or cancel (free of charge). Example: If the 30th is the dock reservation date, it refers to the 10th.

◆Until 19 days agoIf you contact us, the date and time can be changed once for free, but subsequent changes will not be possible (it will be treated as a cancellation). Example: If the 30th is the dock reservation date, it will refer to the 11th.

◆18 days before - the day of the testA cancellation fee of 100% of the total test fee will be charged (including changes in date and time and patient).

◆On the day of the testIf the test is canceled or the date and time is changed due to the clinical judgment of our doctor, a doctor consultation fee of ¥33,000 (tax included) will be charged.

We do not accept provisional reservations. This reservation will be accepted in accordance with the cancellation policy.

please note:Please note that there are no exceptions if you are delayed due to a flight delay or traffic jam.
If you are 30 minutes late for your appointment on the day of the test, you will be charged an additional ¥33,000 (tax included) as a doctor's consultation fee, but the test will still be possible.
Furthermore, if you arrive more than 50 minutes after your reservation time, you will be charged an additional doctor's consultation fee of ¥55,000 (tax included), but you will be able to undergo the test (however, the test may be performed depending on the reservation status of other patients). If we are unable to do so, we will treat it as a cancellation on the day).